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The serum complement system in children on continuous ambulatory peritoneal dialysis
R E Reddingius1, C H Schröder, M R Daha
1Department of Paediatrics, Sint Radboud University Hospital, Nijmegen, The Netherlands.
Summary
Continuous ambulatory peritoneal dialysis (CAPD) does not cause complement deficiencies in children. Complement factor levels in CAPD patients were similar to those with renal failure, not controls.
Area of Science:
- Immunology
- Nephrology
- Pediatrics
Background:
- Continuous ambulatory peritoneal dialysis (CAPD) involves fluid exchange, potentially leading to complement factor loss.
- Understanding complement system status in children undergoing CAPD is crucial for assessing immune function.
Purpose of the Study:
- To investigate the hypothesis that CAPD causes complement deficiencies in children.
- To compare complement activity and serum levels in children on CAPD with healthy children and those with preterminal renal failure.
Main Methods:
- Compared classical (CH50) and alternative (AP50) complement activity and serum levels of C1q, C3, C4, C3d, B, D, and P.
- Studied 22 children on CAPD, 44 healthy children, and 12 children with preterminal renal failure (creatinine clearance < 25 mL/min/1.73 m²).
Main Results:
- No significant differences in CH50, AP50, C3, or B levels were found between CAPD and preterminal groups compared to controls.
- Factors C1q, C4, C3d, D, and P were elevated in the CAPD group versus normal controls.
- Factors D and P were also elevated in the preterminal group, with no significant differences between CAPD and preterminal groups for measured factors.
Conclusions:
- Children undergoing CAPD do not exhibit complement deficiencies.
- Elevated C3d and D levels are likely due to reduced renal elimination.
- Increased levels of other complement factors are attributed to renal failure, not CAPD itself.