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Title: Biocompatible Dialysis Solutions Preserve Peritoneal Mesothelial Cell and Vessel Wall Integrity. A Case-Control Study on Human Biopsies.
Authors: del Peso, Gloria
Jiménez-Heffernan, José Antonio
Selgas, Rafael
Remón, César
Ossorio, Marta
Fernández-Perpén, Antonio
Sánchez-Tomero, José Antonio
Cirugeda, Antonio
de Sousa, Erika
Sandoval, Pilar
Díaz, Raquel
López-Cabrera, Manuel
Bajo, María Auxiliadora
Keywords: Peritoneal biopsy;biocompatible dialysis solutions;hyalinizing vasculopathy;mesothelial cell integrity;submesothelial fibrosis
metadata.dc.subject.mesh: Adult
Biocompatible Materials
Blood Vessels
Case-Control Studies
Dialysis Solutions
Epithelial Cells
Epithelial-Mesenchymal Transition
Logistic Models
Middle Aged
Peritoneal Dialysis
Issue Date: 16-Oct-2015
Abstract: ♦ Chronic exposure to conventional peritoneal dialysis (PD) solutions has been related to peritoneal function alterations in PD patients, and associated with mesothelial cell loss, submesothelial fibrosis, vasculopathy, and angiogenesis. In vitro and ex vivo analyses, as well as studies with animal models, have demonstrated that biocompatible PD solutions attenuate these morphological alterations. Our aim was to confirm the morphological benefits of biocompatible solutions in PD patients. ♦ We analyzed biopsies from 23 patients treated with biocompatible solutions (study group, SG), and compared them with a control group (n = 23) treated with conventional solutions (CG), matched for time on PD. ♦ A total of 56.5% of SG patients showed total or partial preservation of mesothelial cells monolayer, in contrast with 26.1% of patients in CG (p = 0.036). Peritoneal fibrosis was not significantly less frequent in SG patients (47.8% SG vs 69.6% CG; p = 0.13). In patients without previous peritonitis, a significantly lower prevalence of fibrosis was present in SG patients (41.7% SG vs 77.8% CG; p = 0.04). Hyalinizing vasculopathy (HV) was significantly lower in SG (4.3% SG vs 30.4% CG; p = 0.02). Cytokeratin-positive fibroblast-like cells were detected in 10 patients (22%), but the prevalence was not significantly lower in SG. In the univariate regression analysis, the use of biocompatible solutions was associated with mesothelial monolayer integrity (p = 0.04) and an absence of vasculopathy (p = 0.04). ♦ The present study demonstrates in vivo in human biopsies that biocompatible solutions are better tolerated by the peritoneum in the medium and long term than conventional solutions.
metadata.dc.identifier.doi: 10.3747/pdi.2014.00038
Appears in Collections:Producción 2020

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