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Proteome profile of peritoneal effluents in children on glucose- or icodextrin-based peritoneal dialysis

Maurizio Bruschi1, Giovanni Candiano, Laura Santucci

  • 1Renal Child's Foundation, Genoa, Italy. mauriziobruschi@yahoo.it

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|June 30, 2010
PubMed

Insights

Icodextrin (Ico) solution shows improved removal of small proteins compared to glucose (Glu) in pediatric peritoneal dialysis. However, Ico also removes more oxidized albumin, with unknown long-term clinical effects.

Area of Science:

  • Proteomics
  • Biochemistry
  • Nephrology

Background:

  • Peritoneal dialysis (PD) utilizes icodextrin (Ico) or glucose (Glu) solutions.
  • Understanding protein profiles and redox status in PD effluents is crucial.

Purpose of the Study:

  • Compare proteome profiles and protein oxido-redox status in peritoneal effluents from pediatric patients using Ico versus Glu solutions.
  • Assess the efficiency of Ico and Glu in removing specific proteins.

Main Methods:

  • Two-dimensional electrophoresis and mass spectrometry analyzed protein composition in effluents from 16 pediatric patients undergoing 14-hour daytime PD dwells.
  • Cyanine labeling quantified oxidized protein products.
  • Compared protein removal kinetics for β2-microglobulin and cystatin C.

Main Results:

  • Icodextrin demonstrated significantly higher peritoneal transport of β2-microglobulin and cystatin C compared to glucose.
  • Proteome analysis revealed more protein spots in Ico effluents, with 314 spots significantly higher than in Glu effluents.
  • Greater amounts of oxidized albumin were found in Ico dialysate, correlating with lower serum albumin levels.

Conclusions:

  • Icodextrin solution is more efficient in removing small proteins during peritoneal dialysis in pediatric patients.
  • The removal of larger proteins and their oxidized forms by Ico may have complex effects.
  • Long-term clinical implications of removing specific molecules, including oxidized proteins, require further investigation.
Abstract

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