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Peritoneal membrane shows progressive thickening, fibrotic changes and neovascularization with time on PD. Peritonitis, uremia and bioincompatible dialysate solution are important causes of peritoneal fibrosis in CAPD patients.
Epithelial to mesenchymal transition (EMT) is one of the important etiologic factors for the peritoneal fibrosis in CAPD patients. Low GDP group showed less EMT than conventional PD group. Adjustment of peritoneal growth factor for dialysate CA125 revealed significant association with EMT suggesting that fibroblastoid transition from HPMC could be affected by the amount of intraperitoneal VEGF per unit mass of HPMC. There was significant improvement in both degree of EMT and D-CA125 at 6th and 12th months after switching from high GDP solution to low GDP solution.
Application of icodextrin solution showed preservation of the peritoneum, like less EMT and high mesothelial bulk mass. In conclusion, therapy with low GDP solution including icodextrin may positively impact on preservation of the peritoneal membrane via reduced EMT. (Korean J Med 74:235-242, 2008)
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