Quantitative assessment of the peritoneal vessel density and vasculopathy in CAPD patients

• Published in: Nephrology, dialysis, transplantation Vol. 21; no. 6; pp. 1675 - 1681
• Main Authors: Sherif, Ali M., Nakayama, Masaaki, Maruyama, Yukio, Yoshida, Hiraku, Yamamoto, Hiroyasu, Yokoyama, Keitaro, Kawakami, Makio
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.06.2006; Oxford Publishing Limited (England)
• Subjects: Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Vessels - growth & development; Blood Vessels - pathology; Emergency and intensive care: renal failure. Dialysis management; Female; Glomerulonephritis; Histological Techniques; Humans; Intensive care medicine; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - therapy; Male; Medical sciences; Microcirculation - pathology; Middle Aged; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; peritoneal dialysis; Peritoneal Dialysis, Continuous Ambulatory - adverse effects; peritoneal membrane; Peritoneum - blood supply; Renal failure; Sclerosis - etiology; Vascular Diseases - etiology; Vascular Diseases - pathology; vasculopathy; Kidney disease; Human; Extrarenal dialysis; Urinary system disease; Hemodialysis; peritoneal membrane; Renal failure; vasculopathy; Peritoneal dialysis
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfl054

Background. Peritoneal sclerosis (PS) complicates continuous ambulatory peritoneal dialysis (CAPD). Exploring the peritoneal vascular changes, which are characteristic histological findings in long-term PD, may give new insight into the basic pathological process leading to PS. We present a quantitative analysis of peritoneal vascular density as well as vasculopathy grades in relation to PD duration. Methods. Peritoneal samples from 56 stable CAPD patients were analysed, and cases with membrane failure were excluded. Patients were classified into four groups according to CAPD duration in years: group A (n = 12), 0 year; group B (n = 11), 1–5 years; group C (n = 17), 5–9 years; and group D (n = 16), >9 years. The total density, of microvessels (capillaries, post-capillary venules and venules) and the density of each vasculopathy grade (0 = intact, 1 = mild, 2 = moderate and 3 = severe) in the compact zone were calculated (numbers/mm2) in each sample and the percentage ratio of each grade in relation to the total vessel density was also determined. Results. There was no significant difference in the total vessel density (P-value = 0.64). In the grade of vasculopathy (density and percentage ratio), there were significant differences among groups, with grade 0 highest in group A, grade 1 highest in group C and grade 3 highest in group D. Conclusion. The results of this study indicate that vascular density does not increase, at least in stable uncomplicated PD, and that intact vessels decrease with time on PD, while the severe grades of vasculopathy predominate especially on a long-term basis.