TISSUE REMODELING AND INFLAMMATION DURING PERITONEAL DIALYSIS: CATHETER VERSUS FLUID

摘要

Peritoneal dialysis (PD) is the first-line renal replacement therapy for approximately 11% of the global dialysis population (1,2). It is now well established that chronic PD induces changes in the structural and func-tionalintegrityofthe peritoneal membrane, compromising treatment efficacy and patient outcomes (3-7). These changes include partial or complete demesothe-lialization, increased submesothelial thickening, and neoangiogenesis, resulting in ultrafiltration failure and altered peritoneal transport functions (4,6). While numerous studies have attributed these morphologic and functional abnormalities to the bioincompatible nature of PD fluids, peritonitis, and uremia, there is now evidence that the dialysis catheter itself can also induce peritoneal inflammation and lead to subsequent structural and functional alterations of the peritoneal membrane (8-10).