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Basic Science and Translational Research in Peritoneal Dialysis

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Nolph and Gokal's Textbook of Peritoneal Dialysis

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Abstract

This chapter describes the basic science and translational research that support the use of the peritoneal cavity as a means of dialysis for anephric patients.

In the first part of this chapter, we discuss the basic and applied clinical science which describes the process of peritoneal dialysis, including the fluid and solute exchanges that occur during the procedure. Details of the physiologic forces, the distributed nature of the barrier, the effects of the interstitial matrix on transport, the nature of the endothelial barrier, the effects of lymphatic absorption from the tissue, and the factors of hydrostatic pressure and the surface area are discussed. Then we relate this to the basic clinical model and demonstrate the connections between the fundamental calculations of the process and those used to characterize the clinical situation. Alternative theories of transperitoneal transport are presented and related to the fundamental principles.

In the second part, recent research is reviewed concerning the molecular signals that occur when a catheter is introduced into the peritoneal cavity and dialysis solutions are administered. There has been a plethora of research concerning the inflammatory signals that may be involved in these processes and in possible ways to prevent the harmful effects. The focus will be on both theoretical and practical ways to slow or halt the changes that often force our patients to switch to hemodialysis. The possibilities of this new knowledge are opening horizons to researchers.

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Authors and Affiliations

  1. Nalecz Institute of Biocybernetics and Biomedical Engineering, Warsaw, Poland

    Joanna Stachowska-Pietka & Jacek Waniewski

  2. Mission of Mercy, Frederick, MD, USA

    Michael Flessner

Authors
  1. Joanna Stachowska-Pietka
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  2. Jacek Waniewski
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  3. Michael Flessner
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Editor information

Editors and Affiliations

  1. Nephrology, School of Medicine Department of Medicine Division of, Columbia, MO, USA

    Ramesh Khanna

  2. Dept. Medicine Div. Nephrology, University of Amsterdam Academic Medical Center, Amsterdam, The Netherlands

    Raymond T. Krediet

Glossary of Terms

AGE

Advanced glycation end product

AP-1

Activator protein 1

APD

Automated peritoneal dialysis

AQP

Aquaporin

ASK

Apoptosis sigma-regulating kinase

BLS

Bicarbonate-lactate solution

BMI

Body mass index

b-PDF

Bicarbonate-buffered peritoneal dialysis fluid

BSA

Body surface area

CA-125

Cancer antigen 125

Caspase

Cysteine-aspartic protease

catenin β1

Protein involved in regulation of cell-cell adhesion and gene transcription

CCL18

Chemokine ligand 18 is produced by the innate immune system

CGRP

Calcitonin gene-related peptide

CTGF

Connective tissue growth factor

CXCL1

Small protein belonging to the CXCL chemokine family

DAMP

Damage-associated molecular patterns

DKK-1

Dickkopf-related protein

EGF

Epithelial growth factor

EMT

Epithelial-to-mesenchymal transition, equivalent to MMT in PD literature

EPS

Encapsulating peritoneal sclerosis

FGF

Fibroblast growth factor

FN

Fibronectin

FWF

Free water fraction

GAG

Glycosaminoglycans

GSK

Glycogen synthase kinase

HB-EGF

Heparin-binding epidermal growth factor

HDAC

Histone deacetylase

HG

High glucose (PDS)

HPG

Hyperbranched polyglycerol

HPMC

Human peritoneal mesothelial cells

Hsp-70

Heat shock protein

ICO

Icodextrin

IL

Interleukin

INF

Interferon

INFγ

Interferon gamma

JAK-STAT

Epithelial effector/signaling molecules

l-PDF

Lactate buffered peritoneal dialysis fluid

LpS

Hydraulic permeability

MCP-1

Monocyte chemoattractant protein 1

MGO

Methylglyoxal

MIP-1β

Macrophage inflammatory protein-1β or CCL4

miR-

micro RNA-

MMP

Matrix metallopeptidase

MMT

Mesothelial-to-mesenchymal transition

MTAC

Mass transfer area coefficient

MTC

Mass transfer coefficient

MW

Molecular weight

NAC

N-Acetyl-L-cysteine

NF-κβ

Nuclear factor kappa-light-chain-enhancer of activated B cells

NOX

NADPH oxidase

P38

P38 mitogen-activated protein kinase

PD

Peritoneal dialysis

PDF

Peritoneal dialysis fluid

PDGF

Platelet-derived growth factor

PDS

Peritoneal dialysis solution

PET

Peritoneal equilibration test

PKC

Protein kinase C

PMC

Peritoneal mesothelial cells

PMF

Peritoneal membrane failure

PPAR

Peroxisome proliferator-activated receptor

PSCA

Peritoneal surface contact area

PYS

Physioneal

Rho

Family of small proteins

ROCK

Rho kinase inhibitor

ROS

Reactive oxygen species

SD

Standard deviation

SET7/9

Lysine methyltransferase

SMA

Smooth muscle actin

SMAD

Main signal transducer of TGF-β family

Snail

Zinc finger protein

sPET

Sequential peritoneal equilibration test

TAN IIA

Sulfotanshinone IIA

TGF

Transforming growth factor

TLR

Toll-like receptor

TNFα

Tumor necrosis factor alpha

UF

Ultrafiltration in PD

UFF

Ultrafiltration failure

VDR

Vitamin D receptor

VEGF

Vascular endothelial growth factor

WNT

Wingless/integrated; signal transduction pathways

WT

Wild type (rodents)

ZEB

Zinc finger E-box-binding homeobox

ZO-1

Zonula occludens protein 1

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Stachowska-Pietka, J., Waniewski, J., Flessner, M. (2021). Basic Science and Translational Research in Peritoneal Dialysis. In: Khanna, R., Krediet, R.T. (eds) Nolph and Gokal's Textbook of Peritoneal Dialysis. Springer, Cham. https://doi.org/10.1007/978-3-319-90760-4_37-1

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