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FIBRONECTIN AND FIBRINOGEN IN THE PLASMA AND DIAL YSATE OF PATIENTS ON CAPD

From the Renal Unit and Renal Research Unit, General Infirmary, Leeds, LSl 3EX.

Plasma and dialysate fluid from 18 patients treated with continuous ambulatory peritoneal dialysis (CAPD) while peritonitis-free, were analysed for fibronectin (FN), fibrinogen (FG), albumin (ALB) and total protein (TP). Mean plasma FG (6.24 g/l) was higher than for normal controls (4.23 g/1; p < 0.001) whereas FN (0.31 g/l) was lower than for normal (0.36 g/l; p < 0.02). Twenty-four hour losses of proteins into the dialysate were as follows: TP = 10.9 g, ALB = 5.2 g, FN = 15.6 mg and FG = 221 mg. Mean dialysate concentration for FN was 2.09 mg/1 and FG 31.1 mg/l. Dialysate FN and FG correlated with dialysate ALB (r = 0.92; p < 0.001, r = 0.60; p < 0.01 respectively) suggesting an ultrafiltrate rather than synthesis within the peritoneum. The weaker correlation for FG and its lower dialysate loss:plasma concentration ratio, (equivalent to 34.9 ml plasma cleared/24 hrs) when compared with FN (51.4 ml, p < 0.01), despite its lower molecular weight, indicated a lower concentration of FG in the dialysate than expected; this would appear to be due to intraperitoneal conversion of fibrin, which may be prevented by addition of heparin to the dialysate.

KEY WORDS: Protein loss; Fibronectin; Fibrinogen.

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