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FASEB Journal : Official Publication of... Jan 2023Peritoneal fibrosis (PF) is an irreversible complication of peritoneal dialysis (PD) that leads to loss of peritoneal membrane function. We investigated PD effluent and...
Peritoneal fibrosis (PF) is an irreversible complication of peritoneal dialysis (PD) that leads to loss of peritoneal membrane function. We investigated PD effluent and serum levels and the tissue expression of chemokine (C-C motif) ligand 8 (CCL8) in patients with PD. Additionally, we investigated their association with PF in a mouse model. Eighty-two end-stage renal disease (ESRD) patients with PD were examined. CCL8 levels were measured via enzyme-linked immunosorbent assays in PD effluents and serum and analyzed with peritoneal transport parameters. Human peritoneal mesothelial cells (hPMCs) were obtained from the PD effluents of 20 patients. Primary cultured hPMCs were treated with recombinant (r) transforming growth factor (TGF)-β, and CCL8 expression was assessed via western blotting. As the duration of PD increased, the concentration of CCL8 in PD effluents significantly increased. Correlations between peritoneal transport parameters and dialysate CCL8 levels were observed. Western blotting analysis showed that CCL8 was upregulated via rTGF-β treatment, accompanied by increases in markers of inflammation, fibrosis, senescence, and apoptosis in hPMCs after induction of fibrosis with rTGF-β. Anti-CCL8 monoclonal antibody (mAb) treatment suppressed the rTGF-β-induced increase in all analyzed markers. Immunohistochemical analysis revealed that CCL8 along with fibrosis- and inflammation-related markers were significantly increased in the PF mouse model. Functional blockade of CCL8 using a CCR8 inhibitor (R243) abrogated peritoneal inflammation and fibrosis in vivo. In conclusion, high CCL8 levels in PD effluents may be associated with an increased risk of PD failure, and the CCL8 pathway is associated with PF. CCL8 blockade can ameliorate peritoneal inflammation and fibrosis.
Topics: Animals; Mice; Humans; Peritoneal Fibrosis; Chemokine CCL8; Peritoneum; Chemokines; Peritonitis; Ligands; Inflammation; Disease Models, Animal
PubMed: 36468785
DOI: 10.1096/fj.202200784R -
Scientific Reports Apr 2020The role of intra-peritoneal mediators in the regulation peritoneal transport is not completely understood. We investigate the relation between longitudinal changes in...
The role of intra-peritoneal mediators in the regulation peritoneal transport is not completely understood. We investigate the relation between longitudinal changes in dialysis effluent level of nuclear factor kappa-B (NF-κB) downstream mediators and the change in peritoneal transport over 1 year. We studied 46 incident PD patients. Their peritoneal transport characteristics were determined after starting PD and then one year later. Concomitant dialysis effluent levels of interleukin-6 (IL-6), cyclo-oxygenase-2 (COX-2) and hepatocyte growth factor (HGF) are determined. There were significant correlations between baseline and one-year dialysis effluent IL-6 and COX-2 levels with the corresponding dialysate-to-plasma creatinine level at 4 hours (D/P4) and mass transfer area coefficient of creatinine (MTAC). After one year, patients who had peritonitis had higher dialysis effluent IL-6 (26.6 ± 17.4 vs 15.1 ± 12.3 pg/ml, p = 0.037) and COX-2 levels (4.97 ± 6.25 vs 1.60 ± 1.53 ng/ml, p = 0.007) than those without peritonitis, and the number of peritonitis episode significantly correlated with the IL-6 and COX-2 levels after one year. In contrast, dialysis effluent HGF level did not correlate with peritoneal transport. There was no difference in any mediator level between patients receiving conventional and low glucose degradation product solutions. Dialysis effluent IL-6 and COX-2 levels correlate with the concomitant D/P4 and MTAC of creatinine. IL-6 and COX-2 may contribute to the short-term regulation of peritoneal transport.
Topics: Aged; Creatinine; Cyclooxygenase 2; Dialysis Solutions; Female; Follow-Up Studies; Hepatocyte Growth Factor; Humans; Interleukin-6; Kidney Failure, Chronic; Longitudinal Studies; Male; Middle Aged; NF-kappa B; Peritoneal Dialysis; Peritoneum; Peritonitis
PubMed: 32296091
DOI: 10.1038/s41598-020-63258-3 -
The Journal of International Medical... Jun 2021Eosinophilic peritonitis (EP) is a well-described complication of peritoneal dialysis that occurs because of an overreaction to constituents that are related to the... (Review)
Review
Eosinophilic peritonitis (EP) is a well-described complication of peritoneal dialysis that occurs because of an overreaction to constituents that are related to the catheter or tubing, peritoneal dialysate, pathogenic infection, or intraperitoneal drug use. EP caused by antibiotic use is rare. We present the case of a patient with cefoperazone and sulbactam-related EP. A 59-year-old woman who was undergoing peritoneal dialysis presented with peritonitis with abdominal pain and turbid peritoneal dialysis. Empiric intraperitoneal cefazolin in combination with cefoperazone and sulbactam was started after peritoneal dialysis effluent cultures were performed. Her peritonitis achieved remission in 2 days with the help of cephalosporin, but she developed EP 1 week later, when her dialysate eosinophil count peaked at 49% of the total dialysate white blood cells (absolute count, 110/mm). We excluded other possible causes and speculated that cefoperazone and sulbactam was the probable cause of EP. The patient continued treatment with cefoperazone and sulbactam for 14 days. EP resolved within 48 hours after stopping cefoperazone and sulbactam. Thus, EP can be caused by cefoperazone and sulbactam use. Physicians should be able to distinguish antibiotic-related EP from refractory peritonitis to avoid technique failure.
Topics: Anti-Bacterial Agents; Cefoperazone; Female; Humans; Middle Aged; Peritoneal Dialysis, Continuous Ambulatory; Peritonitis; Sulbactam
PubMed: 34162261
DOI: 10.1177/03000605211025367 -
Rhode Island Medical Journal (2013) Oct 2022For the 11% of dialysis patients worldwide who receive peritoneal dialysis (PD) to treat their end-stage kidney disease (ESKD), recent PD-associated peritonitis is...
For the 11% of dialysis patients worldwide who receive peritoneal dialysis (PD) to treat their end-stage kidney disease (ESKD), recent PD-associated peritonitis is estimated to contribute to 5-30% of reported mortality.1,2 These infections are most commonly caused by coagulase-negative Staphylococcus (32%), followed by culture-negative peritonitis (16%), and the timely identification and targeted treatment of peritonitis is critical to avoid complications such as PD catheter removal.3 Here, we present a case of atypical Rothia mucilaginosis peritonitis in a PD patient.
Topics: Coagulase; Humans; Micrococcaceae; Peritoneal Dialysis; Peritonitis; Renal Dialysis
PubMed: 36173909
DOI: No ID Found -
Peritoneal Dialysis International :... Mar 2022We report the first case of peritoneal dialysis (PD)-associated peritonitis due to , a thermally dimorphic black fungus transmitted from epiphytotic disease. The patient...
We report the first case of peritoneal dialysis (PD)-associated peritonitis due to , a thermally dimorphic black fungus transmitted from epiphytotic disease. The patient presented with PD-associated peritonitis and fungal colonisation inside the PD catheter's lumen after an exposing 'wet contamination' event with a phytopathogen 11 days prior to the onset of infection. The human pathogen and phytopathogen were confirmed the same species by nucleotide sequences of the internal transcribed spacer and large subunit regions of the ribosomal RNA gene. A 'wet contamination' should be closely monitored for an extended period, and a broader spectrum of organisms might lead to peritonitis, particularly in centres with a high prevalence of fungal infection. PD patients and their caregivers should have periodic retraining of aseptic technique and personnel hygiene. We also recommend a long course of antifungal medication in eradicating peritoneal sporotrichosis to prevent unfavourable outcomes and relapsing peritonitis from this organism.
Topics: Antifungal Agents; Humans; Mycoses; Peritoneal Dialysis; Peritonitis
PubMed: 34587836
DOI: 10.1177/08968608211048063 -
Journal of Veterinary Emergency and... Sep 2021To evaluate the use of a veterinary point-of-care urine culture system (POCUCS) for the diagnosis of septic peritonitis.
OBJECTIVE
To evaluate the use of a veterinary point-of-care urine culture system (POCUCS) for the diagnosis of septic peritonitis.
DESIGN
Prospective feasibility study performed between August 2017 and April 2018.
SETTING
Private referral hospital.
ANIMALS
Twenty samples of naturally occurring canine peritoneal effusion collected via aseptic abdominocentesis.
PROCEDURES
Point-of-care urine culture systems were inoculated and incubated according to manufacturer's instructions. The presence of bacterial growth, estimation of colony-forming units/mL of bacteria, and organism identification were recorded. Bacterial growth and organism identification on POCUCS were compared to an aerobic culture performed at a commercial microbiology laboratory. Serial dilution and subsequent culture on a POCUCS of a confirmed Escherichia coli infected peritoneal effusion and negative control sample were performed to determine the lowest concentration of bacteria detectable.
RESULTS
There were 10 septic and 10 aseptic samples of peritoneal effusion confirmed by aerobic laboratory culture. Of the 10 culture-positive samples, 8 were culture-positive on the POCUCS. The sensitivity and specificity of the POCUCS for the detection of bacteria in peritoneal effusion were 80.0% and 100%, respectively. The POCUCS lowest limit of detectable bacteria in peritoneal effusion was 1000 CFUs/mL.
CONCLUSIONS
The POCUCS evaluated in this study was less sensitive and less rapid for diagnosing septic peritonitis than blood glucose to peritoneal effusion glucose ratio and plasma lactate to peritoneal effusion glucose ratio. This POCUCS is not recommended as a tool for diagnosing septic peritonitis.
Topics: Animals; Ascitic Fluid; Dog Diseases; Dogs; Feasibility Studies; Peritonitis; Point-of-Care Systems; Prospective Studies
PubMed: 34331824
DOI: 10.1111/vec.13098 -
Internal Medicine (Tokyo, Japan) Feb 2024
Topics: Humans; Female; Ascites; Peritoneum; Tuberculosis; Ovarian Neoplasms; Peritonitis, Tuberculous
PubMed: 37344427
DOI: 10.2169/internalmedicine.2013-23 -
The American Surgeon Jan 2023
Topics: Humans; Pharyngitis; Streptococcal Infections; Peritonitis; Streptococcus pyogenes; Sensitivity and Specificity
PubMed: 33131280
DOI: 10.1177/0003134820951497 -
Journal of Nephrology Sep 2023Peritoneal dialysis- (PD) related infections continue to be a major cause of morbidity and mortality in patients on renal replacement therapy via PD. However, despite... (Review)
Review
Peritoneal dialysis- (PD) related infections continue to be a major cause of morbidity and mortality in patients on renal replacement therapy via PD. However, despite the great efforts in the prevention of PD-related infectious episodes, approximately one third of technical failures are still caused by peritonitis. Recent studies support the theory that ascribes to exit-site and tunnel infections a direct role in causing peritonitis. Hence, prompt exit site infection/tunnel infection diagnosis would allow the timely start of the most appropriate treatment, thereby decreasing the potential complications and enhancing technique survival. Ultrasound examination is a simple, rapid, non-invasive and widely available procedure for tunnel evaluation in PD catheter-related infections. In case of an exit site infection, ultrasound examination has greater sensitivity in diagnosing simultaneous tunnel infection compared to the physical exam alone. This allows distinguishing the exit site infection, which will likely respond to antibiotic therapy, from infections that are likely to be refractory to medical therapy. In case of a tunnel infection, the ultrasound allows localizing the catheter portion involved in the infectious process, thus providing significant prognostic information. In addition, ultrasound performed after two weeks of antibiotic administration allows monitoring patient response to therapy. However, there is no evidence of the usefulness of ultrasound examination as a screening tool for the early diagnosis of tunnel infections in asymptomatic PD patients.
Topics: Humans; Catheter-Related Infections; Catheters, Indwelling; Peritoneal Dialysis; Anti-Bacterial Agents; Peritonitis
PubMed: 36939999
DOI: 10.1007/s40620-023-01589-w -
American Family Physician Oct 2022
Topics: Humans; Peritonitis; Albumins; Bacterial Infections; Liver Cirrhosis
PubMed: 36260890
DOI: No ID Found