Fibrosis of Peritoneal Membrane, Molecular Indicators of Aging and Frailty Unveil Vulnerable Patients in Long-Term Peritoneal Dialysis

Patrícia Branco, Rita Calça, Ana Rita Martins, Catarina Mateus, Maria João Jervis, Daniel Pinto Gomes, Sofia Azeredo-Lopes, Antonio Ferreira De Melo Junior, Cátia Sousa, Ester Civantos, Sebastian Mas-Fontao, Augusta Gaspar, Sância Ramos, Judit Morello, Fernando Nolasco, Anabela Rodrigues, Sofia Azeredo Pereira

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4 Citations (Scopus)
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Abstract

Peritoneal membrane status, clinical data and aging-related molecules were investigated as predictors of long-term peritoneal dialysis (PD) outcomes. A 5-year prospective study was conducted with the following endpoints: (a) PD failure and time until PD failure, (b) major cardiovascular event (MACE) and time until MACE. A total of 58 incident patients with peritoneal biopsy at study baseline were included. Peritoneal membrane histomorphology and aging-related indicators were assessed before the start of PD and investigated as predictors of study endpoints. Fibrosis of the peritoneal membrane was associated with MACE occurrence and earlier MACE, but not with the patient or membrane survival. Serum α-Klotho bellow 742 pg/mL was related to the submesothelial thickness of the peritoneal membrane. This cutoff stratified the patients according to the risk of MACE and time until MACE. Uremic levels of galectin-3 were associated with PD failure and time until PD failure. This work unveils peritoneal membrane fibrosis as a window to the vulnerability of the cardiovascular system, whose mechanisms and links to biological aging need to be better investigated. Galectin-3 and α-Klotho are putative tools to tailor patient management in this home-based renal replacement therapy.

Original languageEnglish
Article number5020
JournalInternational Journal of Molecular Sciences
Volume24
Issue number5
DOIs
Publication statusPublished - Mar 2023

Keywords

  • cardiovascular toxicity
  • chronic kidney disease
  • galectin-3
  • uremic toxins
  • α-Klotho

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