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Abstract: SU-OR27

Prognostic Roles of Peritoneal Dialysis Effluent Mitochondrial DNA Level

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Than, Win Hlaing, Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
  • Szeto, Cheuk-Chun, Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
Background

Circulating mitochondrial DNA (mtDNA) level is associated with the systemic inflammatory state and prognosis of peritoneal dialysis (PD) patients. We explore the relation between mtDNA level in PD effluent and peritoneal transport characteristics and outcomes of PD patients.

Methods

We measured PD effluent mtDNA levels by quantitative polymerase chain reaction and the result is expressed as copy per 1000 copies of the housekeeping gene. Both PD effluent sediment and cell-free supernatant mtDNA levels were measured. Peritoneal transport was determined by the peritoneal equilibration test and represented as mass transfer area coefficient (MTAC) of creatinine. All patients were followed for technique and overall survival.

Results

168 PD patients were followed for 41.3 (IQR: 19.3-52.0) months. Their mean age was 60.4±11.8 years; 99 (58.9%) were men. Median PD effluent (PDE) supernatant mtDNA was 255.4 unit (IQR: 157.5-451.3); median PDE sediment mtDNA was 201.6 unit (147.8-267.3). PDE supernatant mtDNA level had a modest but significant correlation with MTAC creatinine (r = -0.364, p<0.001) and the number of previous peritonitis episode (r = -0.235, p=0.002). After adjusting for age, gender, Charlson’s Comorbidity Score, total weekly Kt/V, and residual renal function, PDE sediment mtDNA was a significant predictor of technique survival (adjusted hazards ratio [AHR] 1.002, 95%CI 1.000-1.003, p=0.011). In contrast, PDE sediment mtDNA level did not predict patient survival (p = 0.7). In contrast, the PDE supernatant mtDNA level did not correlate with technique or patient survival.

Conclusion

PDE supernatant mtDNA level had a significant correlation with peritoneal transport. PDE sediment mtDNA level was a significant predictor of technique survival for PD patients. The mechanism of the differential implications between PDE sediment and supernatant mtDNA levels deserves further investigations.