Is peritoneal dialysis causing a measurable burden of inflammatory and endothelial injury on top of metabolic syndrome?
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Low-grade chronic inflammation is present in patients on peritoneal dialysis (PD) and in metabolic syndrome (MS). Due to possible greater endothelial changes in dialyzed patients, inflammatory response and oxidative stress are probably stronger in patients on PD. The objective of the study was to investigate possible in between adipokines, inflammatory, endothelial and oxidative stress markers between MS patients and patients on PD.
Concentrations of adipokines (leptin, resistin), inflammatory markers [interleukin-6 (IL-6), soluble tumor necrosis factor alpha receptor (sTNF-R), myeloperoxidase (MPO), monocyte chemoattractant protein 1 (MCP-1)] and endothelial markers [soluble intracellular adhesion molecule-1 (sICAM-1), soluble CD40 ligand (sCD40L)] were determined in 55 MS patients and 18 patients on PD, with flow cytometry, and visfatin concentration was measured with ELISA. Routine biochemistry parameters were measured on Beckman Coulter AU2700 analyzer.
Patients on PD have significantly higher concentration of: CRP [6.5 (3.7–12.1) versus 2.6 (1.3–4.0) mg/L, P < 0.001], IL-6 [13.83 (8.48–31.31) versus 2.05 (0.67–4.11) pg/mL, P < 0.001], MCP-1 [2172.28 (1563.84–2922.77) versus 1353.58 (1166.33–1961.70) pg/mL, P = 0.023], sTNF-R [18.25 (12.81–25.22) versus 1.23 (0.89–1.43) ng/mL, P < 0.001] and sICAM-1 [830.03 (599.21–967.02) versus 463.85 (315.25–751.71) ng/mL, P = 0.006] than subjects with MS. MS patients have higher concentrations of MPO [175.47 (120.15–231.67) versus 101.76 (53.55–186.06) ng/mL, P = 0.016] and visfatin [1.5 (0.9–2.3) versus 0.9 (0.6–1.6) ng/mL, P = 0.013].
In patients on PD, inflammatory reaction is higher than in patients with MS. On the contrary, patients with MS have stronger oxidative stress response and adipose tissue activity caused probably by the chronic low level of inflammation and underlying metabolic disorders.
KeywordsAdipokines Endothelial impairment Inflammation Metabolic syndrome Oxidative stress Peritoneal dialysis
This study was supported by Ministry of Science, Education and Sports, Republic of Croatia, project Number: 134-1340227-0200.
Compliance with ethical standards
Conflict of interest
The study was approved by the Sestre milosrdnice Medical School University Hospital Ethical Committee. The study was performed in accordance with the principles of Good clinical practice of the International Conference on Harmonization (ICH GCP) and the Declaration of Helsinki.
All participants have signed the informed consent.
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