Biomarkers Related to Peritoneal Transfer Function and Dialysis Adequacy

The main treatment for end-stage renal disease (ESRD) is renal replacement therapy, among which peritoneal dialysis (PD) is easy to perform, inexpensive, and widely used. The internationally adopted Peritoneal Equilibration Test (PET) categorizes peritoneal function into four types based on the dialysate-to-plasma creatinine ratio (D/Pcr). In some patients undergoing long-term PD, changes in peritoneal function lead to a decline in dialysis adequacy, which ultimately results in withdrawal from PD. Among these patients, those with high-transport peritoneal function exhibit higher mortality rates and poorer prognoses compared to patients with low-transport peritoneal function. However, PET fails to identify underlying pathologies (e.g., fibrosis, inflammation). Similarly, dialysis adequacy tests also fail to reveal the underlying causes of changes in dialysis adequacy. Therefore, early identification of the underlying causes of peritoneal function changes and timely clinical interventions may prolong the duration of PD. This review lists biomarkers related to peritoneal transport function that may indicate the causes of altered peritoneal function and could guide clinical treatment protocols in the future.