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Early diagnostic markers for encapsulating peritoneal sclerosis: a case-control study.

Denise E Sampimon1, Mario R Korte, Deirisa Lopes Barreto

  • 1Division of Nephrology, Department of Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. d.e.sampimon@amc.uva.nl

Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis
|February 4, 2010
PubMed
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Lower cancer antigen-125 (CA125) and higher interleukin-6 (IL-6) dialysate levels may predict encapsulating peritoneal sclerosis (EPS) in peritoneal dialysis (PD) patients. These markers show potential for early EPS diagnosis.

Area of Science:

  • Nephrology
  • Peritoneal Dialysis
  • Biomarkers

Background:

  • Encapsulating peritoneal sclerosis (EPS) is a serious complication of long-term peritoneal dialysis (PD).
  • Early diagnosis of EPS is crucial for patient management and outcomes.
  • Identifying reliable early diagnostic markers for EPS remains a challenge.

Purpose of the Study:

  • To investigate the potential of dialysate cancer antigen-125 (CA125), K(+), interleukin-6 (IL-6), and vascular endothelial growth factor (VEGF) as early diagnostic markers for EPS.
  • To analyze the time courses of these markers in patients who developed EPS and in control patients undergoing PD.

Main Methods:

  • Longitudinal collection of dialysate and serum samples from 11 EPS patients and 31 control patients on PD for at least 57 months.

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  • Measurement of CA125 and IL-6 in dialysate, and K(+) and VEGF in both dialysate and serum.
  • Analysis of marker time courses using linear mixed models and calculation of sensitivity/specificity for EPS prediction.

    • Main Results:

    • No significant differences in time courses for K(+) and VEGF were observed between EPS and control groups.
    • Appearance rate of CA125 (AR-CA125) was significantly lower in the last 3 years prior to EPS diagnosis (p < 0.05).
    • Appearance rate of IL-6 (AR-IL-6) tended to be higher 2 years prior to EPS diagnosis (p = 0.09).
    • A combination of AR-CA125 < 33 U/min and AR-IL-6 > 350 pg/min demonstrated 70% sensitivity and 89% specificity for EPS development.

    Conclusions:

    • Dialysate AR-CA125 levels were lower and AR-IL-6 levels tended to be higher in the years preceding EPS diagnosis compared to controls.
    • The combined use of CA125 and IL-6 shows promise as an early diagnostic tool for encapsulating peritoneal sclerosis in PD patients.