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Complement activation during CAPD

G A Young1, S Kendall, A M Brownjohn

  • 1Renal Research Unit, General Infirmary, Leeds, UK.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|January 1, 1993
PubMed
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Complement activation occurs in the peritoneum during continuous ambulatory peritoneal dialysis (CAPD). This may increase infection risk, with findings suggesting alternative pathway generation in the peritoneum.

Area of Science:

  • Immunology
  • Nephrology
  • Complement System Biology

Background:

  • Continuous ambulatory peritoneal dialysis (CAPD) involves direct contact of dialysis fluid with the peritoneal membrane.
  • The role of complement system activation within the peritoneal cavity during CAPD is not fully understood.

Purpose of the Study:

  • To investigate complement activation pathways in CAPD patients compared to healthy individuals.
  • To determine the site of complement activation (plasma vs. peritoneum) during CAPD.

Main Methods:

  • Measurement of complement components (C3, C4, Factor B) and activation markers (Bb, C4d, iC3b, SC5b-9/MAC) in plasma and dialysate.
  • Comparison between 20 CAPD patients and 20 normal individuals.

Main Results:

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  • Elevated levels of soluble membrane attack complex (SC5b-9) in CAPD plasma, not solely due to plasma activation.
  • Higher concentrations of iC3b, Bb, and SC5b-9 in dialysate suggest peritoneal generation, primarily via the alternative pathway.
  • Low levels of C3, C4, and Factor B in dialysate indicate vascular leakage, while C4d suggests minor classical pathway activation.

Conclusions:

  • Complement activation demonstrably occurs within the peritoneal cavity during CAPD.
  • Peritoneal complement activation, particularly via the alternative pathway, may contribute to inflammatory complications and infection risk in CAPD patients.