Cell‐free DNA in the Peritoneal Effluent of Peritoneal Dialysis Solutions

Therapeutic Apheresis and Dialysis - Tập 14 Số 1 - Trang 20-26 - 2010
Jernej Pajek1, Radoslav Kveder, A Guček, Andrej Škoberne, Andrej Bren, Maja Bučar, Darko Černe, Jana Lukač‐Bajalo
1Department of Nephrology, University Medical Center Ljubljana, Zaloska, Slovenia. [email protected]

Tóm tắt

AbstractThe beneficial effects of novel peritoneal dialysis solutions low in glucose degradation products regarding peritoneal cell apoptosis and necrosis are well established in vitro, however in vivo data is lacking. Cell‐free DNA quantification is a possible method to determine cell damage through apoptosis and necrosis in vivo. We performed a prospective, cross‐over study on 26 stable continuous ambulatory peritoneal dialysis (CAPD) patients, treating each patient for 3 months in a randomized order with a conventional, lactate‐buffered, acidic solution (solution D) and a novel, bicarbonate/lactate‐buffered neutral solution (solution P). The timed overnight peritoneal effluent was sampled for cell‐free DNA quantification using a fluorometric assay. The effluent samples of eighteen patients were finally available for DNA quantification. The concentration range of cell‐free DNA in the peritoneal effluents was 1.8–9.5 µg/L. The coefficient of intrapatient variation in overnight effluent cell‐free DNA appearance was 15.6 ± 12.4%. Cell‐free DNA peritoneal appearance using solutions D and P was 14.9 ± 6.8 µg and 11.8 ± 3.4 µg, respectively (P = 0.02), with the average difference of 3.1 µg (95% CI, 0.7–5.6 µg). Our results show that cell‐free DNA is present in the overnight peritoneal effluent of stable CAPD patients. A significant decrease in the cell‐free DNA appearance with solution P was found; however, before accepting this as an indicator of a more biocompatible profile causing less peritoneal membrane cell necrosis and apoptosis, confirmatory data on larger patient samples are needed. Our results indicate the potential future role of cell‐free DNA in the diagnosis and prognosis of therapy‐related peritoneal membrane degeneration.

Từ khóa


Tài liệu tham khảo

10.1681/ASN.V132470

10.1046/j.1523-1755.2002.00135.x

10.1093/ndt/gfh277

10.1046/j.1525-1594.2003.07222.x

Catalan MP, 2001, Acceleration of neutrophil apoptosis by glucose‐containing peritoneal dialysis solutions: role of caspases, J Am Soc Nephrol, 12, 2442, 10.1681/ASN.V12112442

10.1038/ki.1997.495

Ortiz A, 2004, Will modulation of cell death increase PD technique survival?, Perit Dial Int, 24, 105, 10.1177/089686080402400201

Jahr S, 2001, DNA fragments in the blood plasma of cancer patients: quantitations and evidence for their origin from apoptotic and necrotic cells, Cancer Res, 61, 1659

10.1196/annals.1318.036

10.1196/annals.1318.032

10.1159/000213536

10.1373/49.4.562

10.1172/JCI114716

10.1093/clinchem/46.3.319

10.1097/01.CCM.0000074719.40109.95

10.1016/S0272-6386(97)90122-0

Tranaeus A, 2000, A long‐term study of a bicarbonate/lactate‐based peritoneal dialysis solution‐clinical benefits. The Bicarbonate/Lactate Study Group, Perit Dial Int, 20, 516, 10.1177/089686080002000506

Senn S, 1993, Cross‐over Trials in Clinical Research

10.1111/j.1523-1755.2004.00747.x

10.1093/ndt/gfg003

Pajek J, 2008, Short‐term effects of a new bicarbonate/lactate buffered and conventional peritoneal dialysis fluid on peritoneal and systemic inflammation in CAPD patients: a randomized controlled study, Perit Dial Int, 28, 44, 10.1177/089686080802800109

10.1111/j.1749-6632.2000.tb06608.x

Lukač‐Bajalo J, 2005, Pediatrična Pulmologija, (Izbrana Poglavja iz Pediatrije, 17), 65

10.1111/j.1749-6632.2001.tb03869.x

Krediet RT, 2000, Textbook of Peritoneal Dialysis, 149

10.1196/annals.1448.014

Thông tin
Thông tin xuất bản

Therapeutic Apheresis and Dialysis

Tập 14 Số 1

20-26

Thông tin tác giả