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Peritoneal dialysis (PD) is a procedure that facilitates the exchange of solutes, waste products, electrolytes, and excess fluid between the blood in the peritoneal capillaries and a dialysis solution introduced into the peritoneal cavity.Principles of Peritoneal Dialysis (PD)Diffusion: Waste products such as urea and electrolytes move from high concentrations in the blood to low concentrations in the dialysate across the peritoneal membrane. This mechanism is driven by the concentration...
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Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
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Once the process of glomerular filtration is completed, blood carrying unfiltered drug molecules traverses through efferent arterioles and makes its way into the peritubular capillaries in the proximal tubule. A variety of carriers play a pivotal role in actively secreting drugs from these peritubular capillaries into the tubular fluid. The organic anion transporter transfers acidic drugs, against an electrochemical gradient, from the peritubular capillaries into the renal tubule cells and...
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Dialysis is a diffusion-based purification process that separates analyte molecules from a complex matrix. This is accomplished by allowing molecules in the solution to pass through a semipermeable membrane into a liquid on the other side. The membrane is usually made of cellulose acetate or cellulose nitrate, and the second liquid must be miscible with the solution. Ions (e.g., chloride or sodium) or organic molecules (e.g., glucose) can pass through the membrane pores, which generally have...
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Active tubular secretion is a robust, energy-demanding process that utilizes carrier systems to transport drugs into renal tubules. The active renal secretion systems include the organic anion transporter (OAT) for weak acids and the organic cation transporter (OCT) for weak bases. Structurally similar drugs can compete for the same transporter, potentially leading to drug accumulation and toxicity. However, this principle can be exploited therapeutically. One example is probenecid (Probalan),...
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Use of Enzymatic Biosensors to Quantify Endogenous ATP or H2O2 in the Kidney
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Autotaxin concentrations in peritoneal dialysis effluent reflect peritoneal function.

Keisuke Horikoshi1, Norihiko Sakai1,2, Megumi Oshima1

  • 1Department of Nephrology and Rheumatology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.

Therapeutic Apheresis and Dialysis : Official Peer-Reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy
|September 26, 2024
PubMed
Summary

Autotaxin in peritoneal dialysis effluent may serve as a convenient marker for peritoneal function. This study found autotaxin levels correlate with key peritoneal equilibration test (PET) markers, suggesting its clinical utility.

Keywords:
autotaxinperitoneal dialysisperitoneal function

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Area of Science:

  • Nephrology
  • Biomarker Discovery
  • Peritoneal Dialysis

Background:

  • The Peritoneal Equilibration Test (PET) is standard for monitoring peritoneal function in dialysis patients.
  • A simpler, more convenient marker is needed for home care and clinical settings.
  • Autotaxin, linked to tissue fibrosis and increased vascular permeability, is a potential candidate.

Purpose of the Study:

  • To investigate whether autotaxin concentrations in peritoneal dialysis (PD) effluent can reflect peritoneal function.
  • To explore the association between autotaxin levels and established PET parameters.

Main Methods:

  • The study included 45 patients undergoing PD between 2016 and 2021.
  • Autotaxin concentrations were measured in PD effluent.
  • Associations with PET markers, including dialysate/plasma creatinine ratio, glucose ratio, and sodium dip, were analyzed.

Main Results:

  • Autotaxin concentrations in PD effluent were significantly associated with the dialysate/plasma creatinine ratio (p < 0.05).
  • A significant correlation was found between autotaxin levels and the end/start dialysate glucose ratio (p < 0.05).
  • Autotaxin levels also correlated with the dip in dialysate sodium concentration, indicating ultrafiltration capacity (p < 0.05).

Conclusions:

  • Autotaxin concentrations in PD effluent show potential as an adjunct marker for assessing peritoneal function.
  • These findings suggest autotaxin could offer a more accessible method for monitoring PD patients.