International Journal of Molecular Sciences · 17 authors, 10 centres
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This 5-year prospective cohort study of 58 peritoneal dialysis patients found that baseline peritoneal membrane fibrosis was associated with major cardiovascular events (MACE) but not with peritoneal dialysis failure or mortality. Low serum α-Klotho (<742 pg/mL) was a marker for fibrosis and MACE risk, while high galectin-3 (>8.88 ng/mL) predicted PD technique failure. A key limitation is the small, single-center sample.
Cardiovascular disease is a major cause of mortality in chronic kidney disease, and the status of the peritoneal membrane may reflect systemic vulnerability. This study investigated baseline peritoneal membrane fibrosis and aging-related molecules as predictors of long-term outcomes in peritoneal dialysis. METHODS: A prospective cohort of 58 incident patients was followed for 60 months. Baseline peritoneal membrane histomorphology (biopsy score) and serum biomarkers (including α-Klotho and galectin-3) were analyzed as predictors of peritoneal dialysis failure and major cardiovascular events. KEY RESULTS: Baseline peritoneal membrane fibrosis (22 patients) was not associated with PD failure but was independently associated with the occurrence of MACE (27 patients) and earlier time to MACE (median 17 months). A low serum α-Klotho level (<742 pg/mL) was a surrogate for fibrosis and also predicted MACE. In contrast, a high baseline galectin-3 level (>8.88 ng/mL) was independently associated with PD technique failure (41% of patients) and earlier time to failure (median 40 months). Frailty and age were associated with some outcomes but not independently predictive in adjusted models for time to MACE. LIMITATIONS: The study is limited by its small, single-center cohort and the measurement of biomarkers only at baseline. IMPLICATIONS: Peritoneal membrane fibrosis may serve as a window to systemic cardiovascular vulnerability in PD patients. The biomarkers α-Klotho and galectin-3 show promise for risk stratification, though validation is needed.
