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Prognostic significance of peritoneal dialysis effluent mitochondrial DNA level
Win Hlaing Than1, Jack Kit-Chung Ng2, Winston Wing-Shing Fung2
1Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales Hospital, Hong Kong, China; Li Ka Shing Institute of Health Sciences (LiHS), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
Background:
Mitochondrial DNA (mtDNA) resembles bacterial DNA and potentially triggers local and systemic inflammation. We evaluate the prognostic implications of PD effluent mtDNA level in peritoneal dialysis (PD) patients.
Methods:
We measured mtDNA in the PD effluent (PDE) sediment and supernatant of 168 incident PD patients. All patients were followed for hospitalization, technique and overall survival.
Results:
The median PD effluent supernatant and sediment mtDNA levels were 255.4 unit (interquartile range [IQR] 157.5-451.3) and 201.6 unit (IQR 147.8-267.3), respectively. Serum C-reactive protein level closely with PDE sediment mtDNA level (r = 0.471, p < 0.001) and less with supernatant mtDNA level (r = 0.156, p = 0.044). PDE supernatant mtDNA level correlates with dialysate-to-plasma creatinine ratio at 4 h (D/P4) (r = 0.361, p < 0.001) but not with any clinical outcome. PDE sediment mtDNA was an independent predictor of technique survival (p = 0.011) and the duration of hospitalization (p = 0.044) after adjusting for clinical confounding factors.
Conclusions:
PDE sediment mtDNA level significantly correlated with systemic inflammation, while PDE supernatant mtDNA level correlated with peritoneal transport. PDE sediment mtDNA level also independently predicted technique survival and duration of hospitalization. The mechanism of the different implications between PDE sediment and supernatant mtDNA levels deserves further investigations.
Insights
Mitochondrial DNA (mtDNA) in peritoneal dialysis (PD) effluent sediment predicts technique survival and hospitalization duration. PD effluent supernatant mtDNA correlates with peritoneal transport, not clinical outcomes.
Area of Science:
- Nephrology
- Molecular Biology
- Inflammation Research
Background:
- Mitochondrial DNA (mtDNA) shares similarities with bacterial DNA, potentially inducing inflammation.
- The prognostic value of mtDNA in peritoneal dialysis (PD) effluent requires investigation.
Purpose of the Study:
- To evaluate the prognostic implications of mitochondrial DNA (mtDNA) levels in PD effluent.
- To differentiate the clinical relevance of mtDNA in PD effluent sediment versus supernatant.
Main Methods:
- Measured mtDNA in PD effluent (PDE) sediment and supernatant from 168 incident PD patients.
- Monitored patients for hospitalization, technique survival, and overall survival.
Main Results:
- PDE sediment mtDNA levels correlated significantly with serum C-reactive protein, indicating systemic inflammation (r=0.471, p<0.001).
- PDE supernatant mtDNA levels correlated with peritoneal membrane transport (D/P4 ratio, r=0.361, p<0.001).
- PDE sediment mtDNA independently predicted technique survival (p=0.011) and hospitalization duration (p=0.044).
Conclusions:
- PDE sediment mtDNA is linked to systemic inflammation and predicts adverse clinical outcomes in PD patients.
- PDE supernatant mtDNA reflects peritoneal membrane transport characteristics.
- Further research is needed to elucidate the distinct roles of sediment and supernatant mtDNA in PD.
