Peritoneal Fibrosis Clinical Trial
Peritoneal fibrosis (PF) is one of the most serious complications after long-term continuous
ambulatory peritoneal dialysis (CAPD). Human peritoneal fibroblast (HPFB) and extracellular
matrix (ECM) deposition is the most possible causes leading to PF. ECM are mainly
synthesized from HPFB and human peritoneal mesothelial cells (HPMC). In the PF process,
there is decrement in the quantity of HPMC, loss of permeability for lower molecules, and
eventually ultrafiltration failure. This phenomena will result in technique failure.
High glucose content of the dialysate and peritonitis have been claimed as major stimulants
to the development of PF. In each episode of peritonitis, the number of HPMC will decrease.
On the other hand, ECM production will be reinforced by the inflammatory cytokines secreted
by the white cells or HPMC per se. High glucose dialysate will induce the above process with
more chronic stimulation, and PF followed by technique failure is inevitable.
Peritoneal fibrosis is definitively diagnosed with peritoneal biopsy, but this is
inconvenient for most patients. Besides, pathology changes will be noted only after a
substantial loss of peritoneal function. The peritoneal equilibration test (PET) is usually
used as the index of peritoneal function. However, in the chronic process, PET change is
also slow and is unable to be a parameter for treatment outcome. In this study, the factors
predicting PET change will be searched, and they could be an index for evaluation and even a
marker of preventing or treating PF.
In this project, peritoneal dialysis (PD) dialysate will be collected during an annual PET
in each PD patient in the National Taiwan University Hospital (NTUH). Some cytokines that
will be measured include vasculoendothelial growth factor, hyaluronan, transforming growth
factor-β, procollagen, and cancer antigen-125. The same test and measurement will be
performed during PET in the next year. The factors which affect PET results will be analyzed
such as cytokines, glucose exposure, peritonitis incidence, PD duration, gender, age. The
investigators will try to find a convenient acute reactive marker for preventing or treating
PF to monitor the PET change clinically.
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| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Completed |
NCT02513615 -
Epigenetic Determinants of Peritoneal Fibrosis
|