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Published on: July 20, 2022

Sterile solutions and peritoneal inflammation

Michael F Flessner1

  • 1Division of Nephrology, Department of Medicine, University of Mississippi Medical Center, Jackson, Miss., USA.

Contributions to Nephrology
|May 25, 2006
PubMed

There is now abundant evidence in both animal and human studies that sterile dialysis solutions result in the alteration of the peritoneal barrier. Mesothelial cells undergo an epithelialto- mesenchymal transition after less than 1 year of dialysis. After more than 6 years of peritoneal dialysis, there is extensive fibrosis and neoangiogenesis in the sub-mesothelial compact zone. Clinical studies demonstrate that the structural changes correlate with alterations in transport function and progressive ultrafiltration failure. The mechanisms of inflammation include cellular peroxide production, acidic solutions, glucose and its degradation products, and the integrated response of the cellular-cytokine cascade. Basic and translational research efforts are discussed to highlight our current knowledge in this area and the remaining questions.

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