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Application of Bio-Molecular Sciences in Peritoneal Dialysis
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Application of Bio-Molecular Sciences in Peritoneal Dialysis

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Pathology, Diagnostics, and Therapeutics".

Deadline for manuscript submissions: closed (31 March 2022) | Viewed by 19041

Special Issue Editor

Dr. Silvio Borrelli

E-Mail Website
Guest Editor
Unit of Nephrology, Department of Advanced Surgical and Medical Sciences, University of Campania "Luigi Vanvitelli", Piazza Miraglia, 80138 Naples, Italy
Interests: kidney disease; peritoneal dialysis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The prevalence of End Stage Kidney Disease (ESKD) is growing in these last years, due to the aging of the general population and increased prevalence of diabetes and cardiovascular (CV) diseases. This "great wave" of frail elderly patients in need of renal replacement therapy (RRT) poses concerns about the quality of chronic care and economic sustainability. Furthermore, recent pandemic by Coronavirus Covid-19 has highlighted the need to enhance domiciliary care in ESKD patients.

Peritoneal Dialysis (PD) is the most popular home dialysis, representing, however, only 10% of total RRT in Western countries, though no difference in mortality and treatment adequacy was evident, in the face of lower economic burden. Therefore, a wider “PD culture” is desirable in Nephrology world, and not only.

The main aim of this special issue of International Journal of Molecular Science is to provide an update about current knowledge and future perspectives for the treatment of metabolic alterations occurring in ESKD patients. More specifically, we will focus on the recent promising insights about PD that may improve further dialysis efficacy, reducing local and systemic side effects of this treatment.
Potential Topics:

  • Sodium and water in peritoneal dialysis: Mechanisms and solutions
  • Hyperkaliemia in End Stage Kidney Disease: the role of novel therapies.
  • Mineral Bone disease in End Stage Kidney Disease: “Klotho and his brothers”.
  • HIF stabilizers in End Stage Kidney Disease: “every promise is a debt”
  • Fibrosis of peritoneal membrane: target of new therapies in peritoneal dialysis?
  • Glucose load and Insulin-sensitivity in peritoneal dialysis
  • MicroRNAs in dialysis: What future?
  • Proteomics in End Stage Kidney Disease: is there room for it in Nephrology?

Dr. Silvio Borrelli
Guest Editor

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Published Papers (5 papers)

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18 pages, 2761 KiB  
Article
Aquaporin-1 Facilitates Transmesothelial Water Permeability: In Vitro and Ex Vivo Evidence and Possible Implications in Peritoneal Dialysis
by Francesca Piccapane, Andrea Gerbino, Monica Carmosino, Serena Milano, Arduino Arduini, Lucantonio Debellis, Maria Svelto, Rosa Caroppo and Giuseppe Procino
Int. J. Mol. Sci. 2021, 22(22), 12535; https://doi.org/10.3390/ijms222212535 - 21 Nov 2021
Cited by 4 | Viewed by 2717
Abstract
We previously showed that mesothelial cells in human peritoneum express the water channel aquaporin 1 (AQP1) at the plasma membrane, suggesting that, although in a non-physiological context, it may facilitate osmotic water exchange during peritoneal dialysis (PD). According to the three-pore model that [...] Read more.
We previously showed that mesothelial cells in human peritoneum express the water channel aquaporin 1 (AQP1) at the plasma membrane, suggesting that, although in a non-physiological context, it may facilitate osmotic water exchange during peritoneal dialysis (PD). According to the three-pore model that predicts the transport of water during PD, the endothelium of peritoneal capillaries is the major limiting barrier to water transport across peritoneum, assuming the functional role of the mesothelium, as a semipermeable barrier, to be negligible. We hypothesized that an intact mesothelial layer is poorly permeable to water unless AQP1 is expressed at the plasma membrane. To demonstrate that, we characterized an immortalized cell line of human mesothelium (HMC) and measured the osmotically-driven transmesothelial water flux in the absence or in the presence of AQP1. The presence of tight junctions between HMC was investigated by immunofluorescence. Bioelectrical parameters of HMC monolayers were studied by Ussing Chambers and transepithelial water transport was investigated by an electrophysiological approach based on measurements of TEA+ dilution in the apical bathing solution, through TEA+-sensitive microelectrodes. HMCs express Zo-1 and occludin at the tight junctions and a transepithelial vectorial Na+ transport. Real-time transmesothelial water flux, in response to an increase of osmolarity in the apical solution, indicated that, in the presence of AQP1, the rate of TEA+ dilution was up to four-fold higher than in its absence. Of note, we confirmed our data in isolated mouse mesentery patches, where we measured an AQP1-dependent transmesothelial osmotic water transport. These results suggest that the mesothelium may represent an additional selective barrier regulating water transport in PD through functional expression of the water channel AQP1. Full article
(This article belongs to the Special Issue Application of Bio-Molecular Sciences in Peritoneal Dialysis)
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Review

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18 pages, 884 KiB  
Review
Proteomics and Extracellular Vesicles as Novel Biomarker Sources in Peritoneal Dialysis in Children
by Chiara Trincianti, Vincenzo Meleca, Edoardo La Porta, Maurizio Bruschi, Giovanni Candiano, Andrea Garbarino, Xhuliana Kajana, Alberto Preda, Francesca Lugani, Gian Marco Ghiggeri, Andrea Angeletti, Pasquale Esposito and Enrico Verrina
Int. J. Mol. Sci. 2022, 23(10), 5655; https://doi.org/10.3390/ijms23105655 - 18 May 2022
Cited by 4 | Viewed by 3227
Abstract
Peritoneal dialysis (PD) represents the dialysis modality of choice for pediatric patients with end-stage kidney disease. Indeed, compared with hemodialysis (HD), it offers many advantages, including more flexibility, reduction of the risk of hospital-acquired infections, preservation of residual kidney function, and a better [...] Read more.
Peritoneal dialysis (PD) represents the dialysis modality of choice for pediatric patients with end-stage kidney disease. Indeed, compared with hemodialysis (HD), it offers many advantages, including more flexibility, reduction of the risk of hospital-acquired infections, preservation of residual kidney function, and a better quality of life. However, despite these positive aspects, PD may be associated with several long-term complications that may impair both patient’s general health and PD adequacy. In this view, chronic inflammation, caused by different factors, has a detrimental impact on the structure and function of the peritoneal membrane, leading to sclerosis and consequent PD failure both in adults and children. Although several studies investigated the complex pathogenic pathways underlying peritoneal membrane alterations, these processes remain still to explore. Understanding these mechanisms may provide novel approaches to improve the clinical outcome of pediatric PD patients through the identification of subjects at high risk of complications and the implementation of personalized interventions. In this review, we discuss the main experimental and clinical experiences exploring the potentiality of the proteomic analysis of peritoneal fluids and extracellular vesicles as a source of novel biomarkers in pediatric peritoneal dialysis. Full article
(This article belongs to the Special Issue Application of Bio-Molecular Sciences in Peritoneal Dialysis)
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19 pages, 965 KiB  
Review
Fibrosis of Peritoneal Membrane as Target of New Therapies in Peritoneal Dialysis
by Valentina Masola, Mario Bonomini, Silvio Borrelli, Lorenzo Di Liberato, Luigi Vecchi, Maurizio Onisto, Giovanni Gambaro, Roberto Palumbo and Arduino Arduini
Int. J. Mol. Sci. 2022, 23(9), 4831; https://doi.org/10.3390/ijms23094831 - 27 Apr 2022
Cited by 29 | Viewed by 4608
Abstract
Peritoneal dialysis (PD) is an efficient renal replacement therapy for patients with end-stage renal disease. Even if it ensures an outcome equivalent to hemodialysis and a better quality of life, in the long-term, PD is associated with the development of peritoneal fibrosis and [...] Read more.
Peritoneal dialysis (PD) is an efficient renal replacement therapy for patients with end-stage renal disease. Even if it ensures an outcome equivalent to hemodialysis and a better quality of life, in the long-term, PD is associated with the development of peritoneal fibrosis and the consequents patient morbidity and PD technique failure. This unfavorable effect is mostly due to the bio-incompatibility of PD solution (mainly based on high glucose concentration). In the present review, we described the mechanisms and the signaling pathway that governs peritoneal fibrosis, epithelial to mesenchymal transition of mesothelial cells, and angiogenesis. Lastly, we summarize the present and future strategies for developing more biocompatible PD solutions. Full article
(This article belongs to the Special Issue Application of Bio-Molecular Sciences in Peritoneal Dialysis)
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7 pages, 659 KiB  
Review
Volume-Independent Sodium Toxicity in Peritoneal Dialysis: New Insights from Bench to Bed
by Silvio Borrelli, Luca De Nicola, Ilaria De Gregorio, Lucio Polese, Luigi Pennino, Claudia Elefante, Alessandro Carbone, Tiziana Rappa, Roberto Minutolo and Carlo Garofalo
Int. J. Mol. Sci. 2021, 22(23), 12804; https://doi.org/10.3390/ijms222312804 - 26 Nov 2021
Cited by 1 | Viewed by 2405
Abstract
Sodium overload is common in end-stage kidney disease (ESKD) and is associated with increased cardiovascular mortality that is traditionally considered a result of extracellular volume expansion. Recently, sodium storage was detected by Na23 magnetic resonance imaging in the interstitial tissue of the skin [...] Read more.
Sodium overload is common in end-stage kidney disease (ESKD) and is associated with increased cardiovascular mortality that is traditionally considered a result of extracellular volume expansion. Recently, sodium storage was detected by Na23 magnetic resonance imaging in the interstitial tissue of the skin and other tissues. This amount of sodium is osmotically active, regulated by immune cells and the lymphatic system, escapes renal control, and, more importantly, is associated with salt-sensitive hypertension. In chronic kidney disease, the interstitial sodium storage increases as the glomerular filtration rate declines and is related to cardiovascular damage, regardless of the fluid overload. This sodium accumulation in the interstitial tissues becomes more significant in ESKD, especially in older and African American patients. The possible negative effects of interstitial sodium are still under study, though a higher sodium intake might induce abnormal structural and functional changes in the peritoneal wall. Interestingly, sodium stored in the interstial tissue is not unmodifiable, since it is removable by dialysis. Nevertheless, the sodium removal by peritoneal dialysis (PD) remains challenging, and new PD solutions are desirable. In this narrative review, we carried out an update on the pathophysiological mechanisms of volume-independent sodium toxicity and possible future strategies to improve sodium removal by PD. Full article
(This article belongs to the Special Issue Application of Bio-Molecular Sciences in Peritoneal Dialysis)
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14 pages, 592 KiB  
Review
Hypoxia-Inducible Factor Stabilizers in End Stage Kidney Disease: “Can the Promise Be Kept?”
by Giuseppina Crugliano, Raffaele Serra, Nicola Ielapi, Yuri Battaglia, Giuseppe Coppolino, Davide Bolignano, Umberto Marcello Bracale, Antonio Pisani, Teresa Faga, Ashour Michael, Michele Provenzano and Michele Andreucci
Int. J. Mol. Sci. 2021, 22(22), 12590; https://doi.org/10.3390/ijms222212590 - 22 Nov 2021
Cited by 9 | Viewed by 5079
Abstract
Anemia is a common complication of chronic kidney disease (CKD). The prevalence of anemia in CKD strongly increases as the estimated Glomerular Filtration Rate (eGFR) decreases. The pathophysiology of anemia in CKD is complex. The main causes are erythropoietin (EPO) deficiency and functional [...] Read more.
Anemia is a common complication of chronic kidney disease (CKD). The prevalence of anemia in CKD strongly increases as the estimated Glomerular Filtration Rate (eGFR) decreases. The pathophysiology of anemia in CKD is complex. The main causes are erythropoietin (EPO) deficiency and functional iron deficiency (FID). The administration of injectable preparations of recombinant erythropoiesis-stimulating agents (ESAs), especially epoetin and darbepoetin, coupled with oral or intravenous(iv) iron supplementation, is the current treatment for anemia in CKD for both dialysis and non-dialysis patients. This approach reduces patients’ dependence on transfusion, ensuring the achievement of optimal hemoglobin target levels. However, there is still no evidence that treating anemia with ESAs can significantly reduce the risk of cardiovascular events. Meanwhile, iv iron supplementation causes an increased risk of allergic reactions, gastrointestinal side effects, infection, and cardiovascular events. Currently, there are no studies defining the best strategy for using ESAs to minimize possible risks. One class of agents under evaluation, known as prolyl hydroxylase inhibitors (PHIs), acts to stabilize hypoxia-inducible factor (HIF) by inhibiting prolyl hydroxylase (PH) enzymes. Several randomized controlled trials showed that HIF-PHIs are almost comparable to ESAs. In the era of personalized medicine, it is possible to envisage and investigate specific contexts of the application of HIF stabilizers based on the individual risk profile and mechanism of action. Full article
(This article belongs to the Special Issue Application of Bio-Molecular Sciences in Peritoneal Dialysis)
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