Eryptosis Is Altered in Peritoneal Dialysis Patients.


Journal

Blood purification
ISSN: 1421-9735
Titre abrégé: Blood Purif
Pays: Switzerland
ID NLM: 8402040

Informations de publication

Date de publication:
2019
Historique:
received: 11 12 2018
accepted: 04 06 2019
pubmed: 11 7 2019
medline: 16 5 2020
entrez: 11 7 2019
Statut: ppublish

Résumé

Red blood cells (RBCs) undergo programmed cell death known as eryptosis. Triggers of eryptosis include increased cytosolic Ca(2+) concentration, oxidative stress, osmotic shock, energy depletion and several uremic toxins. Little is known about the pathogenesis of eryptosis in peritoneal dialysis (PD) patients; furthermore, its relevance in worsening clinical conditions in these patients is still not completely defined. We investigated eryptosis levels in PD patients and its association with inflammatory and clinical parameters. A total of 46 PD patients and 17 healthy subjects (CTR) were enrolled. All eryptosis measurements were made in freshly isolated RBCs using the flow cytometer. Eryptosis was significantly higher in PD patients than that in CTR (p < 0.001). Eryptosis levels did not differ significantly between PD patients with and without diabetes, with and without hypertension, and with and without cardiovascular disease. Eryptosis showed no significant differences between patients treated with continuous ambulatory PD/automated PD, with Kt/Vurea value ≤1.7 and >1.7, with a negative or positive history of peritonitis. On the contrary, eryptosis showed significantly lower levels in PD patients with weekly creatinine clearance ≥45 L/week/1.73 m2 (2.8%, 1.7-4.9 vs. 5.6%, 5.0-13.5; p= 0.049). Eryptosis showed significantly lower levels in PD patients with residual diuresis (n = 23) than that in patients without (3.7%, 2.6-5.6 vs. 5%, 3.1-16; p = 0.03). In these 23 patients, significant negative correlations between percentage of eryptosis and residual glomerular filtration rate (rGFR; Spearman's rho = -0.51, p = 0.01) and diuresis volume (Spearman's rho = -0.43, p = 0.05) were found. The present study demonstrated higher eryptosis levels in PD patients compared to corresponding levels in CTR. Furthermore, important PD comorbidity and main PD parameters do not influence eryptosis. Importantly, our data have reported an increase in eryptosis levels with progressive residual diuresis and rGFR loss, probably due to decreased uremic toxins clearance.

Sections du résumé

BACKGROUND
Red blood cells (RBCs) undergo programmed cell death known as eryptosis. Triggers of eryptosis include increased cytosolic Ca(2+) concentration, oxidative stress, osmotic shock, energy depletion and several uremic toxins. Little is known about the pathogenesis of eryptosis in peritoneal dialysis (PD) patients; furthermore, its relevance in worsening clinical conditions in these patients is still not completely defined.
OBJECTIVES
We investigated eryptosis levels in PD patients and its association with inflammatory and clinical parameters.
MATERIAL AND METHODS
A total of 46 PD patients and 17 healthy subjects (CTR) were enrolled. All eryptosis measurements were made in freshly isolated RBCs using the flow cytometer.
RESULTS
Eryptosis was significantly higher in PD patients than that in CTR (p < 0.001). Eryptosis levels did not differ significantly between PD patients with and without diabetes, with and without hypertension, and with and without cardiovascular disease. Eryptosis showed no significant differences between patients treated with continuous ambulatory PD/automated PD, with Kt/Vurea value ≤1.7 and >1.7, with a negative or positive history of peritonitis. On the contrary, eryptosis showed significantly lower levels in PD patients with weekly creatinine clearance ≥45 L/week/1.73 m2 (2.8%, 1.7-4.9 vs. 5.6%, 5.0-13.5; p= 0.049). Eryptosis showed significantly lower levels in PD patients with residual diuresis (n = 23) than that in patients without (3.7%, 2.6-5.6 vs. 5%, 3.1-16; p = 0.03). In these 23 patients, significant negative correlations between percentage of eryptosis and residual glomerular filtration rate (rGFR; Spearman's rho = -0.51, p = 0.01) and diuresis volume (Spearman's rho = -0.43, p = 0.05) were found.
CONCLUSIONS
The present study demonstrated higher eryptosis levels in PD patients compared to corresponding levels in CTR. Furthermore, important PD comorbidity and main PD parameters do not influence eryptosis. Importantly, our data have reported an increase in eryptosis levels with progressive residual diuresis and rGFR loss, probably due to decreased uremic toxins clearance.

Identifiants

pubmed: 31291616
pii: 000501541
doi: 10.1159/000501541
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

351-357

Informations de copyright

© 2019 S. Karger AG, Basel.

Auteurs

Grazia Maria Virzì (GM)

Department of Nephrology, Dialysis and Transplant, St Bortolo Hospital, Vicenza, Italy, graziamaria.virzi@gmail.com.
International Renal Research Institute, IRRIV, Vicenza, Italy, graziamaria.virzi@gmail.com.

Sabrina Milan Manani (S)

Department of Nephrology, Dialysis and Transplant, St Bortolo Hospital, Vicenza, Italy.
International Renal Research Institute, IRRIV, Vicenza, Italy.

Anna Clementi (A)

International Renal Research Institute, IRRIV, Vicenza, Italy.
Department of Nephrology and Dialysis, Santa Marta and Santa Venera Hospital, Acireale, Italy.

Silvia Castegnaro (S)

International Renal Research Institute, IRRIV, Vicenza, Italy.
Hematology Project Foundation, St Bortolo Hospital, Vicenza, Italy.

Alessandra Brocca (A)

Department of Nephrology, Dialysis and Transplant, St Bortolo Hospital, Vicenza, Italy.
International Renal Research Institute, IRRIV, Vicenza, Italy.
Unit of Internal Medicine and Hepatology, Department of Medicine, University of Padova, Padova, Italy.

Caterina Riello (C)

Department of Nephrology, Dialysis and Transplant, St Bortolo Hospital, Vicenza, Italy.

Massimo de Cal (M)

Department of Nephrology, Dialysis and Transplant, St Bortolo Hospital, Vicenza, Italy.
International Renal Research Institute, IRRIV, Vicenza, Italy.

Anna Giuliani (A)

Department of Nephrology, Dialysis and Transplant, St Bortolo Hospital, Vicenza, Italy.
International Renal Research Institute, IRRIV, Vicenza, Italy.

Giovanni Giorgio Battaglia (GG)

Department of Nephrology and Dialysis, Santa Marta and Santa Venera Hospital, Acireale, Italy.

Carlo Crepaldi (C)

Department of Nephrology, Dialysis and Transplant, St Bortolo Hospital, Vicenza, Italy.
International Renal Research Institute, IRRIV, Vicenza, Italy.

Claudio Ronco (C)

Department of Nephrology, Dialysis and Transplant, St Bortolo Hospital, Vicenza, Italy.
International Renal Research Institute, IRRIV, Vicenza, Italy.
Department of Medicine, University of Padova, Padova, Italy.

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