A case of encapsulating peritoneal sclerosis at the clinical early stage with high concentration of matrix metalloproteinase-2 in peritoneal effluent

• Published in: Clinical and experimental nephrology Vol. 9; no. 1; pp. 85 - 89
• Main Authors: Masunaga, Yoshinori, Hirahara, Ichiro, Shimano, Yasumasa, Kurosu, Megumi, Iimura, Osamu, Miyata, Yukio, Amemiya, Morimasa, Homma, Sumiko, Kusano, Eiji, Asano, Yasushi
• Format: Journal Article
• Language: English
• Published: Japan Springer Nature B.V 01.03.2005
• Subjects: Ascitic Fluid - enzymology; Enzyme-Linked Immunosorbent Assay; Female; Humans; Matrix Metalloproteinase 2 - metabolism; Middle Aged; Osmolar Concentration; Peritoneal Dialysis, Continuous Ambulatory - adverse effects; Peritoneal Diseases - diagnosis; Peritoneal Diseases - enzymology; Peritoneal Diseases - etiology; Peritoneal Diseases - pathology; Radiography, Abdominal; Sclerosis; Tomography, X-Ray Computed; Ultrasonography
• ISSN: 1342-1751; 1437-7799
• DOI: 10.1007/s10157-004-0328-5

In encapsulating peritoneal sclerosis (EPS), matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinases are involved in the remodeling of peritoneal tissue. We measured the MMP-2 concentration in the peritoneal effluents of a patient with EPS who discontinued continuous ambulatory peritoneal dialysis (CAPD) therapy because of ultrafiltration failure and/or underdialysis. First, we report a 58-year-old female patient who discontinued CAPD therapy because of underdialysis. Several months after cessation of CAPD, she complained of slightly blood-colored ascites and had an elevated level of C-reactive protein (CRP) in plasma. She was diagnosed as having clinical early-stage EPS. Peritoneal effluents drained from this case, and from 11 patients who discontinued CAPD therapy because of ultrafiltration failure and/or underdialysis, and who underwent peritoneal lavage with 1.5% dextrose peritoneal dialysis fluid for several months, were analyzed by gelatin zymography. MMP-2 concentration was also measured by enzyme-linked immunosorbent assay (ELISA). MMP-2 concentration in peritoneal effluent of this patient was highest compared with that of the other patients. There was some tendency of a positive correlation between MMP-2 concentration per 1 g protein and D/Pcr, and was negative correlation between MMP-2 concentration per 1 g of protein and D/D0 glucose. We concluded that MMP-2 is involved in the peritoneal remodeling of long-term CAPD therapy and the progression of EPS.