論文

査読有り 国際誌
2020年5月21日

Vasculopathy plays an important role during the development and relapse of encapsulating peritoneal sclerosis with conventional peritoneal dialysis solutions.

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
  • Mitsuhiro Tawada
  • Yasuhiko Ito
  • Masataka Banshodani
  • Masahiro Yamashita
  • Sadanori Shintaku
  • Ting Sun
  • Yasuhiro Suzuki
  • Hiroshi Kinashi
  • Yoko Kubo
  • Masahiko Ando
  • Makoto Yamaguchi
  • Takayuki Katsuno
  • Masashi Mizuno
  • Hideki Kawanishi
  • 全て表示

36
8
開始ページ
1519
終了ページ
1526
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1093/ndt/gfaa073

BACKGROUND: Encapsulating peritoneal sclerosis (EPS) is an uncommon but life-threatening complication of peritoneal dialysis (PD) therapy. The causative factors of EPS remain unclear. Pathological studies of the peritoneum affected by EPS and relationships with clinical factors including PD solutions remain lacking. The objective of this study was to examine peritoneal samples from EPS patients and to identify the associations of peritoneal pathology with different clinical factors. METHODS: Peritoneal specimens were obtained at the time of surgical enterolysis in Tsuchiya General Hospital from 1993 to 2016. A total of 223 PD patients were enrolled and analyzed. Tissues were fixed with formalin and processed with hematoxylin and eosin and Masson's trichrome staining, as well as immunohistochemical staining for CD31 and CD68. RESULTS: Evaluations could be made in 174 patients who received surgical enterolysis. Conventional or pH-neutral low-glucose degradation product PD solutions were utilized during PD treatment. The conventional PD solution group showed less angiogenesis (P = 0.013) but more severe vasculopathy, in the form of a lower ratio of luminal diameter to vessel diameter (L/V ratio) (P < 0.001) in association with longer PD treatment. Multivariate Cox proportional hazard models revealed that L/V ratio (per 0.1 increase, hazard ratio = 0.88, 95% confidence interval 0.77-0.99, P = 0.047) was significantly associated with a lower incidence of EPS relapse. In contrast, most of the cases in the pH-neutral solution group showed milder vasculopathy. CONCLUSIONS: The pathology of EPS differed between conventional and pH-neutral solution groups. Vasculopathy was related to the development and relapse of EPS in the conventional solution group.

リンク情報
DOI
https://doi.org/10.1093/ndt/gfaa073
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32437531
ID情報
  • DOI : 10.1093/ndt/gfaa073
  • PubMed ID : 32437531

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