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Clinical and Experimental Nephrology

, Volume 23, Issue 1, pp 122–134 | Cite as

Differences in peritoneal solute transport rates in peritoneal dialysis

  • Marina Asano
  • Takako Ishii
  • Akiyoshi Hirayama
  • Masashi Mizuno
  • Yasuhiro Suzuki
  • Fumiko Sakata
  • Shin-ichi Akiyama
  • Shoichi Maruyama
  • Tomoyoshi Soga
  • Hiroshi Kinashi
  • Takayuki Katsuno
  • Yasuhiko ItoEmail author
Original Article
  • 124 Downloads

Abstract

Background

Ultrafiltration failure associated with peritoneal membrane dysfunction is one of the main complications for patients on long-term peritoneal dialysis (PD). The dialysate-to-plasma concentration ratio (D/P) of creatinine is widely used to assess peritoneal membrane function. However, other small-sized solutes have not been studied in detail as potential indicators of peritoneal permeability.

Methods

We studied the D/Ps of small, middle-sized and large molecules in peritoneal equilibration tests in 50 PD patients. We applied metabolomic analysis of comprehensive small molecular metabolites using capillary electrophoresis time-of-flight mass spectrometry.

Results

D/Ps of middle-sized and large molecules correlated positively with D/P creatinine. Most D/Ps of small molecules correlated positively with D/P creatinine. Among 38 small molecules contained in the dialysate, urea, citrulline and choline showed significantly lower ability to permeate than creatinine. In the relationship between D/Ps of creatinine and small molecules, regression coefficients of three molecules were less than 0.3, representing no correlation to D/P creatinine. Five molecules showed negative regression coefficients. Among these molecules, hippurate and 3-indoxyl sulfate showed relatively high teinpro binding rates, which may affect permeability. Serum concentrations of two molecules were higher in the Low Kt/V group, mainly due to high protein binding rates.

Conclusions

D/Ps of some molecules did not correlate with D/P creatinine. Factors other than molecular weight, such as charge and protein binding rate, are involved in peritoneal transport rates. Metabolomic analysis appears useful to analyze small molecular uremic toxins, which could accumulate in PD patients, and the status of peritoneal membrane transport for each molecule.

Keywords

Peritoneal dialysis D/P creatinine Metabolite Metabolomic analysis Peritoneal membrane dysfunction 

Notes

Compliance with ethical standards

Conflict of interest

The authors have declared that no conflicts of interest exist.

Supplementary material

10157_2018_1611_MOESM1_ESM.pptx (79 kb)
Supplementary material 1 (PPTX 78 KB)
10157_2018_1611_MOESM2_ESM.pptx (84 kb)
Supplementary material 2 (PPTX 83 KB)

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Copyright information

© Japanese Society of Nephrology 2018

Authors and Affiliations

  • Marina Asano
    • 1
  • Takako Ishii
    • 1
  • Akiyoshi Hirayama
    • 2
  • Masashi Mizuno
    • 1
  • Yasuhiro Suzuki
    • 1
  • Fumiko Sakata
    • 1
  • Shin-ichi Akiyama
    • 1
  • Shoichi Maruyama
    • 1
  • Tomoyoshi Soga
    • 2
  • Hiroshi Kinashi
    • 3
  • Takayuki Katsuno
    • 3
  • Yasuhiko Ito
    • 3
    Email author
  1. 1.Department of Nephrology and Renal Replacement TherapyNagoya University Graduate School of MedicineNagoyaJapan
  2. 2.Institute for Advanced BiosciencesKeio UniversityTsuruokaJapan
  3. 3.Department of Nephrology and RheumatologyAichi Medical UniversityNagakuteJapan

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