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Abstract: TH-PO399

Association Between Serum Diamine Oxidase, D-Lactic Acid, and Peritoneal Dialysis Related Peritonitis

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Author

  • Jia, Jieshuang, Shanghai general hospital, Shanghai, China
Background

Abdominal infection is one of serious complications of peritoneal dialysis patients. Studies have shown dysfunctional intestinal barrier seriously affects the efficacy of peritoneal dialysis, and increases serum diamine oxidase(DAO) and D-lactic acid(DLA) levels.

Methods

To investigate the changes of DAO and DLA in patients with peritoneal dialysis-associated abdominal infection, and to find predictable indicators of abdominal infection.We collected 45 peritoneal dialysis patients from January 2017 to January 2018. They include 30 patients without abdominal infection and 15 patients with abdominal infection. We observe the serum levels of DAO, DLA, albumin(ALB), hemoglobin(Hb), interleukin-6(IL-6), and tumor necrosis Factorα(TNFα).

Results

1. In the patients with abdominal infection,the levels of DAO 18.7±4.9(U/L), DLA 40.1±10.2(mg/L), IL-6 12.8±3.5(pg/ml), TNFα18.9±6.7 (pg/ml)(P<0.05) after abdominal infection were significantly higher than those before abdominal infection. 2. In the patients without infection, the levels of DAO 2±0.5 (U/L), DLA 10±2 (mg/L), IL-6 2.8±2.1 (pg/ml) and TNFα4.2±3.4 (pg/ml) (P<0.05) were obviously lower than those of pre-infection indicators in patients with abdominal infection.3.In patients with abodminal infection, pre-infection serum ALB 25.1±5.6 (g/L), Hb 90±10.7 (g/L) (P<0.05) decreased compared with the data in non-infection group. 4. According to the medical histories we found that in the 15 cases of abdominal infection, 10 cases had a history of diarrhea. Among them, 3 cases of patients had taken drugs regulating intestinal flora;In contrast to patients without drugs, the interval of abdominal infection were prolonged from 1.5 ± 2 months to 10±5.3 months (P>0.05), the levels of DAO, DLA, IL-6 and TNFα were decreased(P<0.05),and ALB and Hb levels were decreased(P>0.05).

Conclusion

Serum DAO, DLA levels may be predictors of peritoneal dialysis abdominal infection;Intestinal barrier disorders induces elevated DAO and DLA which induce the increase of inflammatory cytokines IL-6 and TNFα, affect the nutritional status of patients, decrease ALB and Hb level and promote the abdominal infection; drugs regulating intestinal bacteria prolong the period of infection but the data are not statistically significant. Large sample studies are needed. The mechanism how intestinal barrier dysfunction induced abdominal infection needs further study.

Funding

  • Private Foundation Support