[Type III procollagen N-peptide and hyaluronate in serum and dialysate of CAPD patients]

Long-term CAPD may develop peritoneal fibrosis, which is thought to be related to permanent loss of ultrafiltration capacity and sclerosing peritonitis. In CAPD patients, we examined the serum (P-) and effluent (D-) levels of type III procollagen N-peptide (P III P) and hyaluronate (HA), which are expected to change concomitantly with a local increase in submesothelial extracellular matrix of the peritoneum. We selected 40 CAPD patients (age: 46.3 +/- 11.3 years, time on CAPD: 33.6 +/- 26.2 months), who were not suffering from chronic liver disease, any inflammatory disease, nor peritonitis during the previous month. P-P III P, P-HA, D-P III P, and D-HA were measured by PET (values after 4-hour dwelling). D/P ratios (P III P 0.330 +/- 0.137, HA 5.68 +/- 6.44) suggested that their source was from the peritoneum. Although neither P-P III P nor log P-HA value had a significant correlation with age nor time on CAPD, both had significantly positive correlations (p = 0.0009, 0.0005, respectively) with time on total dialysis (including hemodialysis). D-P III P did not have a significant correlation with age nor time on total dialysis but had a significantly positive correlation (p = 0.0098) with D/P-creatinine. Although log D-HA had significantly positive correlations with time on CAPD and time on total dialysis (p = 0.0007, 0.0051, respectively), time on CAPD was first entered (F = 16.5) and time on total dialysis was removed (F to enter: 4) by stepwise regression analysis. In conclusion, a local increase in extracellular matrix of the peritoneum in CAPD patients, indicated by increases in P III P and HA in the effluent, may be related to higher peritoneal permeability and a longer duration of PD.