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Rafael Selgas - One of the best experts on this subject based on the ideXlab platform.

  • preventing Peritoneal membrane fibrosis in Peritoneal dialysis patients
    Kidney International, 2016
    Co-Authors: Qin Zhou, Gloria Del Peso, M A Bajo, Rafael Selgas
    Abstract:

    Long-term Peritoneal dialysis causes morphologic and functional changes in the Peritoneal membrane. Although mesothelial-mesenchymal transition of Peritoneal mesothelial cells is a key process leading to Peritoneal fibrosis, and bioincompatible Peritoneal dialysis solutions (glucose, glucose degradation products, and advanced glycation end products or a combination) are responsible for altering mesothelial cell function and proliferation, mechanisms underlying these processes remain largely unclear. Peritoneal fibrosis has 2 cooperative parts, the fibrosis process itself and the inflammation. The link between these 2 processes is frequently bidirectional, with each one inducing the other. This review outlines our current understanding about the definition and pathophysiology of Peritoneal fibrosis, recent studies on key fibrogenic molecular machinery in Peritoneal fibrosis, such as the role of transforming growth factor-β/Smads, transforming growth factor-β β/Smad independent pathways, and noncoding RNAs. The diagnosis of Peritoneal fibrosis, including effluent biomarkers and the histopathology of a Peritoneal Biopsy, which is the gold standard for demonstrating Peritoneal fibrosis, is introduced in detail. Several interventions for Peritoneal fibrosis based on biomarkers, cytology, histology, functional studies, and antagonists are presented in this review. Recent experimental trials in animal models, including pharmacology and gene therapy, which could offer novel insights into the treatment of Peritoneal fibrosis in the near future, are also discussed in depth.

  • mesenchymal conversion of mesothelial cells as a mechanism responsible for high solute transport rate in Peritoneal dialysis role of vascular endothelial growth factor
    American Journal of Kidney Diseases, 2005
    Co-Authors: Luiz S Aroeira, Abelardo Aguilera, Rafael Selgas, Jose Antonio Sancheztomero, Marta Ramirezhuesca, Luisa M Perezlozano, A Cirugeda, Auxiliadora M Bajo, Gloria Del Peso, Jose A Jimenezheffernan
    Abstract:

    Background: During Peritoneal dialysis (PD), the peritoneum is exposed to bioincompatible dialysis fluids that cause epithelial-to-mesenchymal transition of mesothelial cells, fibrosis, and angiogenesis. Ultrafiltration failure is associated with high transport rates and increased vascular surface, indicating the implication of vascular endothelial growth factor (VEGF). Sources of VEGF in vivo in PD patients remain unclear. We analyzed the correlation between epithelial-to-mesenchymal transition of mesothelial cells and both VEGF level and Peritoneal functional decline. Methods: Effluent mesothelial cells were isolated from 37 PD patients and analyzed for mesenchymal conversion. Mass transfer coefficient for creatinine (Cr-MTC) was used to evaluate Peritoneal function. VEGF concentration was measured by using standard procedures. Peritoneal Biopsy specimens from 12 PD patients and 6 controls were analyzed immunohistochemically for VEGF and cytokeratin expression. Results: Nonepithelioid mesothelial cells from effluent produced a greater amount of VEGF ex vivo than epithelial-like mesothelial cells ( P P r = 0.6; P r = 0.8; P r = 0.35; P Conclusion: These results suggest that mesothelial cells that have undergone epithelial-to-mesenchymal transition are the main source of VEGF in PD patients and therefore may be responsible for a high Peritoneal transport rate.

  • Peritoneal dialysis and epithelial to mesenchymal transition of mesothelial cells
    The New England Journal of Medicine, 2003
    Co-Authors: Maria Yanezmo, Abelardo Aguilera, Rafael Selgas, Jose Antonio Sancheztomero, Enrique Larapezzi, Marta Ramirezhuesca, Carme Dominguezjimenez, Jose A Jimenezhefferna, Auxiliadora M Ajo, V Alvarez
    Abstract:

    Background During continuous ambulatory Peritoneal dialysis, the peritoneum is exposed to bioincompatible dialysis fluids that cause denudation of mesothelial cells and, ultimately, tissue fibrosis and failure of ultrafiltration. However, the mechanism of this process has yet to be elucidated. Methods Mesothelial cells isolated from effluents in dialysis fluid from patients undergoing continuous ambulatory Peritoneal dialysis were phenotypically characterized by flow cytometry, confocal immunofluorescence, Western blotting, and reverse-transcriptase polymerase chain reaction. These cells were compared with mesothelial cells from omentum and treated with various stimuli in vitro to mimic the transdifferentiation observed during continuous ambulatory Peritoneal dialysis. Results were confirmed in vivo by immunohistochemical analysis performed on Peritoneal-Biopsy specimens. Results Soon after dialysis is initiated, Peritoneal mesothelial cells undergo a transition from an epithelial phenotype to a mesenchym...

Kazuho Honda - One of the best experts on this subject based on the ideXlab platform.

  • Significance of new membrane formation in Peritoneal biopsies of Peritoneal dialysis patients: a case–control study
    BMC, 2017
    Co-Authors: Kazuho Honda, Chieko Hamada, Masaaki Nakayama, Masanobu Miyazaki, Kunio Kawanishi, Yasuhiko Ito, On Behalf Of The Peritoneal Pathology Study Committee Of Japanese Society Of Peritoneal Dialysis
    Abstract:

    Abstract Background Newly formed membrane (NFM) on the Peritoneal membrane proper is a unique pathological hallmark of encapsulating Peritoneal sclerosis (EPS), but its definition and diagnostic significance have not been well described. This study investigated the pathological features of NFM in EPS and prevalence of NFM in Peritoneal Biopsy at catheter removal. Methods This multicenter retrospective, observational study was conducted by the Japanese Society of Peritoneal Dialysis and enrolled ten patients with and 52 without EPS at Peritoneal Biopsy during enterolysis surgery or catheter removal. All patients were treated using conventional, acidic Peritoneal dialysis (PD) solutions. Thirty of the 52 non-EPS patients perform Peritoneal lavage once daily after completing PD to prevent the development of EPS and 22 discontinued PD without lavage. NFM was defined as additional membrane structure on the peritoneum that is properly characterized by exudative or fibrous matrices and fibroblast-like cells. Immunostaining of fibrin and podoplanin was performed for the evaluation of NFM. Results NFM was confirmed histologically in eight of the ten patients with EPS. It was also detected in 13 of the 30 patients (43.3%) in the post-PD lavage group and in one of the 22 patients (4.5%) in the non-lavage group. The NFM histology showed various stages of EPS pathology, from early exudative changes with fibrin deposition (stage I; n = 5), progressing to proliferative and fibrosing changes with podoplanin-positive fibroblast-like cells (stage II; n = 9), and finally resulting in adhesive and fibrous scar formation (stage III; n = 8). Immunostaining of fibrin and podoplanin was helpful for evaluating the stage of the NFM. Conclusions NFM contributes the encapsulation of intestines and is a pathological hallmark of EPS, but can be detected microscopically in patients without EPS, especially those with Peritoneal lavage after PD. New membrane formation starts insidiously in Peritoneal membrane damaged by PD treatment, but does not necessarily lead to the development of EPS

  • neutral solution low in glucose degradation products is associated with less Peritoneal fibrosis and vascular sclerosis in patients receiving Peritoneal dialysis
    Peritoneal Dialysis International, 2013
    Co-Authors: Kunio Kawanishi, Kazuho Honda, Misao Tsukada, Hideaki Oda, Kosaku Nitta
    Abstract:

    ♦ Bac kground: T he ef fects of novel biocompatible Peritoneal dialysis (PD) solutions on human Peritoneal membrane pathology have yet to be determined. Quantitative evaluation of human Peritoneal Biopsy specimens may reveal the effects of the new solutions on Peritoneal membrane pathology. ♦ Me thods: Peritoneal specimens from 24 PD patients being treated with either acidic solution containing highglucose degradation products [GDPs (n = 12)] or neutral solution with low GDPs (n = 12) were investigated at the end of PD. As controls, pre-PD Peritoneal specimens, obtained from 13 patients at PD catheter insertion, were also investigated. The extent of Peritoneal fibrosis, vascular sclerosis, and advanced glycation end-product (AGE) accumulation were evaluated by quantitative or semi-quantitative methods. The average densities of CD31-positive vessels and podoplanin-positive lymphatic vessels were also determined. ♦ R esults: Peritoneal membrane fibrosis, vascular sclerosis, and AGE accumulation were significantly suppressed in the neutral group compared with the acidic group. The neutral group also showed lower Peritoneal equilibration test scores and preserved ultrafiltration volume. The density of blood capillaries, but not of lymphatic capillaries, was significantly increased in the neutral group compared with the acidic and pre-PD groups. ♦ Conclusions: Neutral solutions with low GDPs are associated with less Peritoneal membrane fibrosis and vascular sclerosis through suppression of AGE accumulation. However, contrary to expectation, blood capillary density was increased in the neutral group. The altered contents of the new PD solutions modified perito neal membrane morphology and function in patients undergoing PD.

  • impact of uremia diabetes and Peritoneal dialysis itself on the pathogenesis of Peritoneal sclerosis a quantitative study of Peritoneal membrane morphology
    Clinical Journal of The American Society of Nephrology, 2008
    Co-Authors: Kazuho Honda, Chieko Hamada, Masaaki Nakayama, Masanobu Miyazaki, Ali M Sherif, Takashi Harada, Hiroshi Hirano
    Abstract:

    Background and objectives: Peritoneal interstitial fibrosis and hyalinizing vasculopathy were induced by Peritoneal dialysis and other associated conditions ( e.g. , uremia). A quantitative method for Peritoneal Biopsy evaluation is required to investigate possible causative factors and severity of the Peritoneal dialysis–related Peritoneal alterations. Design, setting, participants, & measurements: Peritoneal Biopsy specimens from 173 uremic (before Peritoneal dialysis) and 80 Peritoneal dialysis patients with or without impaired ultrafiltration capacity were evaluated by average Peritoneal thickness of submesothelial compact zone measured at five randomly selected points of peritoneum and by lumen/vessel diameter ratio at postcapillary venule. Results: The average Peritoneal thickness was increased in uremic patients and progressively thickened as the duration of Peritoneal dialysis prolonged. The lumen/vessel diameter ratio was lower in uremia than normal and progressively decreased as the duration of Peritoneal dialysis prolonged. In pre–Peritoneal dialysis peritoneum, patients with diabetes showed significant decrease in lumen/vessel diameter ratio compared with patients without diabetes. The average Peritoneal thickness was significantly higher in patients with impaired ultrafiltration capacity than in patients with maintained ultrafiltration capacity; however, no significant difference was observed in the postcapillary venule thickness and lumen/vessel diameter ratio between the two groups. Conclusions: The average Peritoneal thickness and lumen/vessel diameter ratio were useful morphologic parameters to quantify the severity of the Peritoneal alterations in uremic and Peritoneal dialysis patients. Uremia and diabetes had an impact on the pathogenesis of Peritoneal sclerosis in pre–Peritoneal dialysis peritoneum. Peritoneal dialysis treatment itself had a much stronger impact on the progression of Peritoneal sclerosis.

  • accumulation of advanced glycation end products in the Peritoneal vasculature of continuous ambulatory Peritoneal dialysis patients with low ultra filtration
    Nephrology Dialysis Transplantation, 1999
    Co-Authors: Kazuho Honda, Kosaku Nitta, Shigeru Horita, Wako Yumura, Hiroshi Nihei, Ryoji Nagai, Kazuyoshi Ikeda, Seikoh Horiuchi
    Abstract:

    Advanced glycation end products (AGEs) are formed Methods. Peritoneal Biopsy specimens from 14 CAPD by a non-enzymatic reaction between reduced sugar patients with low ultra-filtration (n=9) and high ultra- and protein, known as the Maillard reaction [1,2]. filtration (n=5) capacity were immunohistochemically AGEs accumulate on serum proteins and various tissue investigated using a monoclonal antibody against AGEs proteins in patients with diabetes mellitus (DM ), sug(6D12). The severity of Peritoneal fibrosis, microvascu- gesting that they play a role in the pathogenesis of lar sclerosis and intensity of AGE accumulation were diabetic complications [3‐6 ]. Recently, several reports semi-quantitatively evaluated. Peritoneal ultra-filtration have disclosed AGE accumulation in sera and tissues capacity was evaluated by calculating daily ultra- of chronic renal failure (CRF ) patients, irrespective of filtration volume per body weight ( UFV/BW ) and D/D 0 the presence or absence of DM [7‐10]. In CRF (glucose) of the Peritoneal equilibration test. patients, AGEs are formed due to high oxidative stress Results. In all patients with low ultra-filtration, AGE associated with the uraemic state [11]. The high conaccumulated in the Peritoneal fibrous tissue and micro- centration of glucose in the Peritoneal dialysate of vascular walls. Remarkably, AGE accumulated more continuous ambulatory Peritoneal dialysis (CAPD) intensely in hyalinized fibrosis of small venular media. patients has been shown to facilitate AGE formation Extent of AGE accumulation in Peritoneal interstitium in the Peritoneal membrane [9,12]. and vascular walls correlated with the progression We recently described the marked Peritoneal vascular of interstitial fibrosis (r=0.727, P=0.0088) and vas- changes in CAPD patients with ultra-filtration failure, cular sclerosis (r=0.915, P=0.001). UFV/BW was in- i.e. severe fibrosis and hyalinization of the media of versely correlated to interstitial fibrosis (r=‐0.660, small venules [13]. The present study was designed to P=0.0174), microvascular sclerosis (r=‐0.671, evaluate the contribution of AGE in the development P=0.0155) and microvascular AGE accumulation of Peritoneal lesions associated with ultra-filtration (r=‐0.678, P=0.0145). failure. Semi-quantitative analysis disclosed that the Conclusions. In CAPD patients, AGE formation in severity of Peritoneal changes were positively correlated the peritoneum correlates with the development of with the grade of AGE accumulation. Furthermore, severe interstitial fibrosis and microvascular sclerosis, which is associated clinically with impaired Peritoneal an inverse relationship between Peritoneal ultraultra-filtration. filtration capacity represented by daily ultra-filtration volume per body weight ( UFV/BW ) and histological changes was also observed. In addition, the pathogen

Alla Turlakow - One of the best experts on this subject based on the ideXlab platform.

  • Peritoneal Carcinomatosis: Role of 18F-FDG PET
    2015
    Co-Authors: Alla Turlakow, Steven M Larson
    Abstract:

    Peritoneal carcinomatosis can be difficult to diagnose, as CT is insensitive, with Peritoneal Biopsy and lavage often subject to problems of sampling error. The aim of our study was to eval-uate the role of 18F-FDG PET in detecting Peritoneal carcinoma-tosis in patients with stomach, ovarian, and adrenal cancer and mesothelioma and to compare the results with CT scans in the same patient group. Our secondary aim was to identify charac-teristic patterns of abdominal 18F-FDG uptake in Biopsy-proven Peritoneal disease and to correlate these patterns with available histologic and anatomic findings after surgery and structural imaging. Methods: The medical records of 88 patients with stomach (n 48), ovarian (n 13), and adrenal cancer (n 6) and mesothelioma (n 21) were reviewed for the presence of Peritoneal tumor on 18F-FDG PET and CT scans. The results were correlated with either contemporaneous Peritoneal Biopsy or ascitic aspirate or with radiographic or clinical follow-up if histology was negative or unavailable. Of 24 patients with sus-pected Peritoneal tumor, 17 had Biopsy-proven findings of peri-toneal disease. Results: Of the 24 patients with suspected Peritoneal tumor, 18F-FDG PET was positive in 14 patients, with 1 of these scans being false-positive, CT was positive in 10 patients, and either PET or CT was positive in 18 patients. This yielded sensitivities of 57 % (13/23), 42 % (10/23), and 78 % (18/23), with uniformly high positive predictive values of 93 % (13/14), 100 % (10/10), and 95 % (18/19), respectively. We identified 2 distinctly abnormal scintigraphic patterns of focal and uniform 18F-FDG uptake corresponding to nodular and diffuse Peritoneal disease on pathologic examination. Conclusion: 18F-FDG PET adds to conventional imaging in the staging of Peritoneal car-cinomatosis. It is also a useful diagnostic tool when Peritoneal Biopsy is either unavailable or inappropriate. We have identified 2 distinct scintigraphic patterns that appear to predict the pres-ence of either nodular or diffuse Peritoneal pathology. Key Words: Peritoneal carcinomatosis; 18F-FDG PET; scinti-graphic pattern

  • Peritoneal carcinomatosis role of 18f fdg pet
    The Journal of Nuclear Medicine, 2003
    Co-Authors: Alla Turlakow, Henry W Yeung, Aida Sanchez Salmon, Homer A Macapinlac, Steven M Larson
    Abstract:

    UNLABELLED: Peritoneal carcinomatosis can be difficult to diagnose, as CT is insensitive, with Peritoneal Biopsy and lavage often subject to problems of sampling error. The aim of our study was to evaluate the role of (18)F-FDG PET in detecting Peritoneal carcinomatosis in patients with stomach, ovarian, and adrenal cancer and mesothelioma and to compare the results with CT scans in the same patient group. Our secondary aim was to identify characteristic patterns of abdominal (18)F-FDG uptake in Biopsy-proven Peritoneal disease and to correlate these patterns with available histologic and anatomic findings after surgery and structural imaging. METHODS: The medical records of 88 patients with stomach (n = 48), ovarian (n = 13), and adrenal cancer (n = 6) and mesothelioma (n = 21) were reviewed for the presence of Peritoneal tumor on (18)F-FDG PET and CT scans. The results were correlated with either contemporaneous Peritoneal Biopsy or ascitic aspirate or with radiographic or clinical follow-up if histology was negative or unavailable. Of 24 patients with suspected Peritoneal tumor, 17 had Biopsy-proven findings of Peritoneal disease. RESULTS: Of the 24 patients with suspected Peritoneal tumor, (18)F-FDG PET was positive in 14 patients, with 1 of these scans being false-positive, CT was positive in 10 patients, and either PET or CT was positive in 18 patients. This yielded sensitivities of 57% (13/23), 42% (10/23), and 78% (18/23), with uniformly high positive predictive values of 93% (13/14), 100% (10/10), and 95% (18/19), respectively. We identified 2 distinctly abnormal scintigraphic patterns of focal and uniform (18)F-FDG uptake corresponding to nodular and diffuse Peritoneal disease on pathologic examination. CONCLUSION: (18)F-FDG PET adds to conventional imaging in the staging of Peritoneal carcinomatosis. It is also a useful diagnostic tool when Peritoneal Biopsy is either unavailable or inappropriate. We have identified 2 distinct scintigraphic patterns that appear to predict the presence of either nodular or diffuse Peritoneal pathology.

Steven M Larson - One of the best experts on this subject based on the ideXlab platform.

  • Peritoneal Carcinomatosis: Role of 18F-FDG PET
    2015
    Co-Authors: Alla Turlakow, Steven M Larson
    Abstract:

    Peritoneal carcinomatosis can be difficult to diagnose, as CT is insensitive, with Peritoneal Biopsy and lavage often subject to problems of sampling error. The aim of our study was to eval-uate the role of 18F-FDG PET in detecting Peritoneal carcinoma-tosis in patients with stomach, ovarian, and adrenal cancer and mesothelioma and to compare the results with CT scans in the same patient group. Our secondary aim was to identify charac-teristic patterns of abdominal 18F-FDG uptake in Biopsy-proven Peritoneal disease and to correlate these patterns with available histologic and anatomic findings after surgery and structural imaging. Methods: The medical records of 88 patients with stomach (n 48), ovarian (n 13), and adrenal cancer (n 6) and mesothelioma (n 21) were reviewed for the presence of Peritoneal tumor on 18F-FDG PET and CT scans. The results were correlated with either contemporaneous Peritoneal Biopsy or ascitic aspirate or with radiographic or clinical follow-up if histology was negative or unavailable. Of 24 patients with sus-pected Peritoneal tumor, 17 had Biopsy-proven findings of peri-toneal disease. Results: Of the 24 patients with suspected Peritoneal tumor, 18F-FDG PET was positive in 14 patients, with 1 of these scans being false-positive, CT was positive in 10 patients, and either PET or CT was positive in 18 patients. This yielded sensitivities of 57 % (13/23), 42 % (10/23), and 78 % (18/23), with uniformly high positive predictive values of 93 % (13/14), 100 % (10/10), and 95 % (18/19), respectively. We identified 2 distinctly abnormal scintigraphic patterns of focal and uniform 18F-FDG uptake corresponding to nodular and diffuse Peritoneal disease on pathologic examination. Conclusion: 18F-FDG PET adds to conventional imaging in the staging of Peritoneal car-cinomatosis. It is also a useful diagnostic tool when Peritoneal Biopsy is either unavailable or inappropriate. We have identified 2 distinct scintigraphic patterns that appear to predict the pres-ence of either nodular or diffuse Peritoneal pathology. Key Words: Peritoneal carcinomatosis; 18F-FDG PET; scinti-graphic pattern

  • Peritoneal carcinomatosis role of 18f fdg pet
    The Journal of Nuclear Medicine, 2003
    Co-Authors: Alla Turlakow, Henry W Yeung, Aida Sanchez Salmon, Homer A Macapinlac, Steven M Larson
    Abstract:

    UNLABELLED: Peritoneal carcinomatosis can be difficult to diagnose, as CT is insensitive, with Peritoneal Biopsy and lavage often subject to problems of sampling error. The aim of our study was to evaluate the role of (18)F-FDG PET in detecting Peritoneal carcinomatosis in patients with stomach, ovarian, and adrenal cancer and mesothelioma and to compare the results with CT scans in the same patient group. Our secondary aim was to identify characteristic patterns of abdominal (18)F-FDG uptake in Biopsy-proven Peritoneal disease and to correlate these patterns with available histologic and anatomic findings after surgery and structural imaging. METHODS: The medical records of 88 patients with stomach (n = 48), ovarian (n = 13), and adrenal cancer (n = 6) and mesothelioma (n = 21) were reviewed for the presence of Peritoneal tumor on (18)F-FDG PET and CT scans. The results were correlated with either contemporaneous Peritoneal Biopsy or ascitic aspirate or with radiographic or clinical follow-up if histology was negative or unavailable. Of 24 patients with suspected Peritoneal tumor, 17 had Biopsy-proven findings of Peritoneal disease. RESULTS: Of the 24 patients with suspected Peritoneal tumor, (18)F-FDG PET was positive in 14 patients, with 1 of these scans being false-positive, CT was positive in 10 patients, and either PET or CT was positive in 18 patients. This yielded sensitivities of 57% (13/23), 42% (10/23), and 78% (18/23), with uniformly high positive predictive values of 93% (13/14), 100% (10/10), and 95% (18/19), respectively. We identified 2 distinctly abnormal scintigraphic patterns of focal and uniform (18)F-FDG uptake corresponding to nodular and diffuse Peritoneal disease on pathologic examination. CONCLUSION: (18)F-FDG PET adds to conventional imaging in the staging of Peritoneal carcinomatosis. It is also a useful diagnostic tool when Peritoneal Biopsy is either unavailable or inappropriate. We have identified 2 distinct scintigraphic patterns that appear to predict the presence of either nodular or diffuse Peritoneal pathology.

Seikoh Horiuchi - One of the best experts on this subject based on the ideXlab platform.

  • accumulation of advanced glycation end products in the Peritoneal vasculature of continuous ambulatory Peritoneal dialysis patients with low ultra filtration
    Nephrology Dialysis Transplantation, 1999
    Co-Authors: Kazuho Honda, Kosaku Nitta, Shigeru Horita, Wako Yumura, Hiroshi Nihei, Ryoji Nagai, Kazuyoshi Ikeda, Seikoh Horiuchi
    Abstract:

    Advanced glycation end products (AGEs) are formed Methods. Peritoneal Biopsy specimens from 14 CAPD by a non-enzymatic reaction between reduced sugar patients with low ultra-filtration (n=9) and high ultra- and protein, known as the Maillard reaction [1,2]. filtration (n=5) capacity were immunohistochemically AGEs accumulate on serum proteins and various tissue investigated using a monoclonal antibody against AGEs proteins in patients with diabetes mellitus (DM ), sug(6D12). The severity of Peritoneal fibrosis, microvascu- gesting that they play a role in the pathogenesis of lar sclerosis and intensity of AGE accumulation were diabetic complications [3‐6 ]. Recently, several reports semi-quantitatively evaluated. Peritoneal ultra-filtration have disclosed AGE accumulation in sera and tissues capacity was evaluated by calculating daily ultra- of chronic renal failure (CRF ) patients, irrespective of filtration volume per body weight ( UFV/BW ) and D/D 0 the presence or absence of DM [7‐10]. In CRF (glucose) of the Peritoneal equilibration test. patients, AGEs are formed due to high oxidative stress Results. In all patients with low ultra-filtration, AGE associated with the uraemic state [11]. The high conaccumulated in the Peritoneal fibrous tissue and micro- centration of glucose in the Peritoneal dialysate of vascular walls. Remarkably, AGE accumulated more continuous ambulatory Peritoneal dialysis (CAPD) intensely in hyalinized fibrosis of small venular media. patients has been shown to facilitate AGE formation Extent of AGE accumulation in Peritoneal interstitium in the Peritoneal membrane [9,12]. and vascular walls correlated with the progression We recently described the marked Peritoneal vascular of interstitial fibrosis (r=0.727, P=0.0088) and vas- changes in CAPD patients with ultra-filtration failure, cular sclerosis (r=0.915, P=0.001). UFV/BW was in- i.e. severe fibrosis and hyalinization of the media of versely correlated to interstitial fibrosis (r=‐0.660, small venules [13]. The present study was designed to P=0.0174), microvascular sclerosis (r=‐0.671, evaluate the contribution of AGE in the development P=0.0155) and microvascular AGE accumulation of Peritoneal lesions associated with ultra-filtration (r=‐0.678, P=0.0145). failure. Semi-quantitative analysis disclosed that the Conclusions. In CAPD patients, AGE formation in severity of Peritoneal changes were positively correlated the peritoneum correlates with the development of with the grade of AGE accumulation. Furthermore, severe interstitial fibrosis and microvascular sclerosis, which is associated clinically with impaired Peritoneal an inverse relationship between Peritoneal ultraultra-filtration. filtration capacity represented by daily ultra-filtration volume per body weight ( UFV/BW ) and histological changes was also observed. In addition, the pathogen