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Open Access Research article

Shorter daily dwelling time in peritoneal dialysis attenuates the epithelial-to-mesenchymal transition of mesothelial cells

Yi-Che Lee16, Yau-Sheng Tsai6, Shih-Yuan Hung15, Tsun-Mei Lin2, Sheng-Hsiang Lin6, Hung-Hsiang Liou9, Hsiang-Chun Liu7, Min-Yu Chang1, Hsi-Hao Wang1, Li-Chun Ho16, Yi-Ting Chen1, Hsin-Pao Chen3, Hong-Arh Fan3, Kuang-Wen Liu3, Yung-Tang Kung3, Hao-Kuang Wang4 and Yuan-Yow Chiou68*

Author Affiliations

1 Division of Nephrology, Department of Internal Medicine, E-DA Hospital/I-Shou University, Kaohsiung, Taiwan

2 Department of Laboratory Medicine, E-DA Hospital/I-Shou University, Kaohsiung, Taiwan

3 Division of Colorectal Surgery, Department of Surgery, E-DA Hospital/I-Shou University, Kaohsiung, Taiwan

4 Department of Neurosurgery, E-DA Hospital/I-Shou University, Kaohsiung, Taiwan

5 Department of Health Management, I-Shou University, Kaohsiung, Taiwan

6 Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan

7 Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan

8 Department of Pediatrics, National Cheng Kung University Hospital, Medical College, No. 138, Sheng-Li Road, Tainan City 701, Taiwan

9 Division of Nephrology, Department of Medicine, Hsin-Jen Hospital, New Taipei City, Taiwan

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BMC Nephrology 2014, 15:35  doi:10.1186/1471-2369-15-35

Published: 20 February 2014

Abstract

Background

Peritoneal dialysis (PD) therapy is known to induce morphological and functional changes in the peritoneal membrane. Long-term exposure to conventional bio-incompatible dialysate and peritonitis is the main etiology of inflammation. Consequently, the peritoneal membrane undergoes structural changes, including angiogenesis, fibrosis, and hyalinizing vasculopathy, which ultimately results in technique failure. The epithelial-to-mesenchymal transition (EMT) of mesothelial cells (MCs) plays an important role during the above process; however, the clinical parameters associated with the EMT process of MCs remain to be explored.

Methods

To investigate the parameters impacting EMT during PD therapy, 53 clinical stable PD patients were enrolled. EMT assessments were conducted through human peritoneal MCs cultured from dialysate effluent with one consistent standard criterion (MC morphology and the expression of an epithelial marker, cytokeratin 18). The factors potentially associated with EMT were analyzed using logistic regression analysis. Primary MCs derived from the omentum were isolated for the in vitro study.

Results

Forty-seven percent of the patients presented with EMT, 28% with non-EMT, and 15% with a mixed presentation. Logistic regression analysis showed that patients who received persistent PD therapy (dwelling time of 24 h/day) had significantly higher EMT tendency. These results were consistent in vitro.

Conclusions

Dwelling time had a significant effect on the occurrence of EMT on MCs.

Keywords:
Dwelling time; Epithelial-to-mesenchymal transition; Mesothelial cells; Peritoneal dialysis