Significance of Peritoneal Albumin Excretion in New Peritoneal Dialysis Patients / 대한신장학회지

ABSTRACT

PURPOSE: High peritoneal transport status is known to be related with the cardiovascular risk. One of the hypotheses that explain the relationship between peritoneal permeability and atherosclerosis is chronic inflammation and endothelial dysfunction. Microalbuminuria is a well-known marker of endothelial dysfunction and a predictor of cardiovascular disease (CVD). We hypothesized that peritoneal albumin excretion, like microalbuminuria, may be related to the cardiovascular events and chronic inflammation in peritoneal dialysis (PD) patients. METHODS: We enrolled eighty-five patients who started PD. Pre-existing CVD was defined as angina, history of MI, cerebrovascular disease, or peripheral arterial disease. Modified peritoneal equilibration test was performed within 2 months. At that time, peritoneal albumin excretion, serum and dialysate IL-6, CRP were measured. RESULTS: The age was 49.5+/-14 years and male-to-female ratio was 1 to 3. Diabetes mellitus and CVD were present in 40% and 28%, respectively. The dialysate-to-plasma albumin (D/Palb) was correlated with D/P4 Cr (r= 0.552, p<0.001), and was higher in HA/H group than in LA/L group (0.19+/-0.008 vs. 0.12+/-0.005, p<0.001). D/Palb was closely correlated with the dialysate IL-6 (r=0.432, p< 0.001), but not with the serum IL-6 and CRP. There were no differences in the peritoneal albumin excretion with respect to the diabetic status or pre-existing CVD. CONCLUSION: The peritoneal albumin excretion was associated with peritoneal small solute transport and dialysate IL-6 in the new PD patients. Prospective studies will follow in order to verify the role of peritoneal albumin excretion as a predictor of cardiovascular events.