Relative contributions of pseudohypoxia and inflammation to peritoneal alterations with long-term peritoneal dialysis patients
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F22%3A00083663" target="_blank" >RIV/00023001:_____/22:00083663 - isvavai.cz</a>
Result on the web
<a href="https://journals.lww.com/cjasn/Fulltext/2022/08000/Relative_Contributions_of_Pseudohypoxia_and.25.aspx" target="_blank" >https://journals.lww.com/cjasn/Fulltext/2022/08000/Relative_Contributions_of_Pseudohypoxia_and.25.aspx</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.2215/CJN.15371121" target="_blank" >10.2215/CJN.15371121</a>
Alternative languages
Result language
angličtina
Original language name
Relative contributions of pseudohypoxia and inflammation to peritoneal alterations with long-term peritoneal dialysis patients
Original language description
Long-termperitoneal dialysis is associated with alterations in peritoneal function, like the development of high small solute transfer rates and impaired ultrafiltration. Also, morphologic changes can develop, the most prominent being loss of mesothelium, vasculopathy, and interstitial fibrosis. Current research suggests peritoneal inflammation as the driving force for these alterations. In this review, the available evidence for inflammation is examined and a new hypothesis is put forward consisting of high glucose-induced pseudohypoxia. Hypoxia of cells is characterized by a high (oxidized-reduced nicotinamide dinucleotide ratio) NADH-NAD1 ratio in their cytosol. Pseudohypoxia is similar but occurs when excessive amounts of glucose are metabolized, as is the case for peritoneal interstitial cells in peritoneal dialysis. The glucose-induced high NADH-NAD1 ratio upregulates the hypoxia-inducible factor-1 gene, which stimulates not only the glucose transporter-1 gene but also many profibrotic genes like TGFb, vascular endothelial growth factor, plasminogen activator inhibitor-1, and connective tissue growth factor, all known to be involved in the development of peritoneal fibrosis. This review discusses the causes and consequences of pseudohypoxia in peritoneal dialysis and the available options for treatment and prevention. Reducing peritoneal exposure to the excessively high dialysate glucose load is the cornerstone to avoid the pseudohypoxia-induced alterations. This can partly be done by the use of icodextrin or by combinations of low molecular mass osmotic agents, all in a low dose. The addition of alanyl-glutamine to the dialysis solution needs further clinical investigation.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30217 - Urology and nephrology
Result continuities
Project
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Continuities
N - Vyzkumna aktivita podporovana z neverejnych zdroju
Others
Publication year
2022
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Clinical journal of the American Society of Nephrology
ISSN
1555-9041
e-ISSN
1555-905X
Volume of the periodical
17
Issue of the periodical within the volume
8
Country of publishing house
US - UNITED STATES
Number of pages
8
Pages from-to
1259-1266
UT code for WoS article
000921864300002
EID of the result in the Scopus database
2-s2.0-85130119319