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Perit Dial Int 24(6): 597-600 2004
© 2004 International Society for Peritoneal Dialysis
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Peritoneal Dialysis International, Vol 24, Issue 6, 597-600
Copyright © 2004 by International Society for Peritoneal Dialysis

Articles

Acute systemic inflammation is associated with an increase in peritoneal solute transport rate in chronic peritoneal dialysis patients

SB Kim, JW Chang, SK Lee, and JS Park

Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

BACKGROUND: This study was performed to evaluate the effects of acute systemic inflammation on peritoneal solute transport rate (PSTR) in chronic peritoneal dialysis (CPD) patients. METHODS: A baseline standard peritoneal equilibration test (PET) was performed on each patient every 6 months, and blood concentration of high-sensitivity C-reactive protein (hs-CRP) was assayed every 2 months in our peritoneal dialysis clinic. Acute systemic inflammation was defined as a greater than 10-fold increase in hs-CRP concentration compared with baseline value, in the absence of peritonitis, and returning to baseline level in 2 months. In patients with acute systemic inflammation, PET and hs-CRP concentration assays were performed during inflammation and after recovery. Ten patients with acute systemic inflammation were enrolled in the inflammation group and 42 other patients served as controls. RESULTS: There were no significant changes in hs-CRP and dialysate-to-plasma ratio of creatinine (D/Pcreat) in the control group during the study period. In the inflammation group, median hs-CRP levels at baseline, during acute inflammation, and at recovery were 2.3 mg/L (range 0.3 - 4.5 mg/L), 39.2 mg/L (range 15.1 - 117.4 mg/L), and 3.7 mg/L (range 0.9 - 8.9 mg/L), respectively. Median D/Pcreat increased significantly from baseline (0.64; range 0.55 - 0.98) to time of acute inflammation (0.72; range 0.60 - 0.96) (p < 0.05). The D/Pcreat at recovery was 0.67 (range 0.52 - 0.94), which decreased significantly from time of acute inflammation (p < 0.05). There was no correlation between changes in log (hs-CRP) and changes in D/Pcreat. CONCLUSION: We have shown here that acute systemic inflammation is associated with a temporary increase in PSTR in CPD patients.




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A. S. Rodrigues, M. Almeida, I. Fonseca, M. Martins, M. J. Carvalho, F. Silva, C. Correia, M. J. Santos, and A. Cabrita
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