| Theme |
New Development in CAPD Therapy |
| Title |
Angiogenesis in peritoneal membranes of peritoneal dialysis patients |
| Author |
Katsushige Abe |
Second Department of Internal Medicine, Nagasaki University School of Medicine |
| Author |
Masanobu Miyazaki |
Second Department of Internal Medicine, Nagasaki University School of Medicine |
| Author |
Shigeru Kohno |
Second Department of Internal Medicine, Nagasaki University School of Medicine |
| [ Summary ] |
Long term peritoneal dialysis (PD) is associated with several structural and functional alterations in the peritoneal membrane. From a morphological point of view, loss of mesothelial cells, interstitial fibrosis and vascular changes, including vascular wall thickening and increased angiogenesis, have been described. From a functional point of view, ultrafiltration failure is the most frequent transport abnormality in long term PD, often leading to technical dropout. It has been shown that a decrease in ultrafiltration with time on PD was mainly associated with increased transport of low molecular weight solutes, suggesting an augmentation of the vascular surface area within the peritoneal membrane. In addition, a significant increase in vascular density has been demonstrated in the peritoneum of long term PD patients and the density of vessels is significantly higher in patients with membrane failure and is correlated with the degree of fibrosis. These vascular alterations in the peritoneum may be associated with deterioration of peritoneal functions and these results allow us to speculate that anti-angiogenic therapy may prevent peritoneal damage in patients with long term PD. |