Comparison of Peritoneal Low-Molecular-Weight-Protein-Removal in CCPD and CAPD Patients Based on C-Terminal Agrin Fragment Clearance.

Steubl, Dominik; Roos, Marcel; Hettwer, Stefan; Angermann, Susanne; Wen, Ming; Schmaderer, Christoph; Luppa, Peter; Heemann, Uwe; Renders, Lutz

doi:10.1159/000443419

2016

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Dokumenttyp:: Comparative Study; Journal Article; Observational Study; Research Support, Non-U.S. Gov't; Article
Autor(en):: Steubl, Dominik; Roos, Marcel; Hettwer, Stefan; Angermann, Susanne; Wen, Ming; Schmaderer, Christoph; Luppa, Peter; Heemann, Uwe; Renders, Lutz
Titel:: Comparison of Peritoneal Low-Molecular-Weight-Protein-Removal in CCPD and CAPD Patients Based on C-Terminal Agrin Fragment Clearance.
Abstract:: This study compares the peritoneal elimination of the low-molecular-weight-protein (LMWP) C-terminal agrin fragment (tCAF, size 22 kDa), a promising biomarker for kidney function, in continuous cycling peritoneal dialysis (CCPD) and continuous ambulatory peritoneal dialysis (CAPD).103 sets of serum, 24h-urine and dialysate samples were obtained in 15 CCPD (63 sets) and 11 CAPD (40 sets) patients. Total, renal and peritoneal substrate removals/clearances were measured/calculated for tCAF, creatinine, blood-urea-nitrogen (BUN), cystatin C and albumin and correlated with the peritoneal transport type.Serum und urine concentrations of all biomarkers did not differ between both groups, urinary substrate removal was higher in CAPD patients for all biomarkers due to better residual renal function. Peritoneal substrate removal of tCAF and albumin were significantly higher in CAPD (tCAF: 35.3 vs. 19.3 µg/d, p<0.001; albumin: 4.3 vs. 3.7 g/d, p=0.001), whereas cystatin C and creatinine did not differ between CAPD and CCPD (cystatin: 7.7 vs. 6.1 mg/d, p=0.08, creatinine: 423.9 vs. 456.7 mg/d, p=0.241). BUN was better removed by CCPD (4846.6 vs. 3393.4 mg/d, p<0.001). CAPD patients with high-transporter characteristics had a higher peritoneal tCAF removal compared to high-average-transporters (49.8 vs. 28.4 µg/d, p<0.001), no differences could be detected in CCPD patients between these groups. CAPD patients using icodextrin twice/day had higher peritoneal clearance of tCAF compared to once daily (4.4 vs. 2.8 l/wk/1.73 m2 body-surface-area, p<0.001).CAPD was superior to CCPD concerning peritoneal tCAF removal. This finding was pronounced in high-transporters and CAPD patients using icodextrin twice daily.
Zeitschriftentitel:: Kidney Blood Press Res
Jahr:: 2016
Band / Volume:: 41
Heft / Issue:: 2
Seitenangaben Beitrag:: 175-85
Sprache:: eng
Volltext / DOI:: doi:10.1159/000443419
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/26959245
Print-ISSN:: 1420-4096
TUM Einrichtung:: Fachgebiet Nephrologie (Prof. Heemann); Institut für Klinische Chemie und Pathobiochemie
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