Journal
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
Volume 24, Issue 5, Pages -Publisher
MDPI
DOI: 10.3390/ijms24055020
Keywords
alpha-Klotho; galectin-3; uremic toxins; cardiovascular toxicity; chronic kidney disease
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This study investigated the predictors of long-term peritoneal dialysis (PD) outcomes, including peritoneal membrane status, clinical data, and aging-related molecules. It found that fibrosis of the peritoneal membrane was associated with major cardiovascular events (MACE) occurrence, while serum alpha-Klotho below 742 pg/mL was related to submesothelial thickness. Uremic levels of galectin-3 were associated with PD failure.
Peritoneal membrane status, clinical data and aging-related molecules were investigated as predictors of long-term peritoneal dialysis (PD) outcomes. A 5-year prospective study was conducted with the following endpoints: (a) PD failure and time until PD failure, (b) major cardiovascular event (MACE) and time until MACE. A total of 58 incident patients with peritoneal biopsy at study baseline were included. Peritoneal membrane histomorphology and aging-related indicators were assessed before the start of PD and investigated as predictors of study endpoints. Fibrosis of the peritoneal membrane was associated with MACE occurrence and earlier MACE, but not with the patient or membrane survival. Serum alpha-Klotho bellow 742 pg/mL was related to the submesothelial thickness of the peritoneal membrane. This cutoff stratified the patients according to the risk of MACE and time until MACE. Uremic levels of galectin-3 were associated with PD failure and time until PD failure. This work unveils peritoneal membrane fibrosis as a window to the vulnerability of the cardiovascular system, whose mechanisms and links to biological aging need to be better investigated. Galectin-3 and alpha-Klotho are putative tools to tailor patient management in this home-based renal replacement therapy.
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