engleski

Dialysate cancer antigen 125 concentration in peritoneal dialysis patients – less is more?

Objectives. Long-term peritoneal dialysis (PD) induces changes in peritoneal membrane function. Adequate dialysis presrciption can be determined by conducting peritoneal equilibration test (PET). Cancer antigen 125 (CA125) in peritoneal effluent is a marker of mesothelial cell mass and may reflect peritoneal fibrosis status. Our aim was to investigate correlation between alterations in PET transporter status and creatinine dialysate to plasma (D/P) ratio with dialysate CA125 concentration in two-year follow-up among PD patients. Methods. We prospectively analysed incident PD patients between January 2013 and January 2016 in Clinical Hospital Centre Rijeka. Measurements were performed 1 month after beginning of PD and every 6 months afterwards. Patients with 4 measurements were included. On the day of measurement blood laboratory test were performed and medical records' data was collected. The peritoneal membrane characteristics were assessed by PET after 4h dwell with 2, 27% glucose and CA125 was determined in the same effluent. Results. We analysed 39 PD patients, mean age 57±15 years (range 27-85 years), PD duration 11, 35±11, 81 months, 24(61%) men, 14(36%) with diabetes, 25(64%) on continuous ambulatory PD. CA125 levels had an increasing trend throughout investigation but without significant difference between baseline and follow-up (p=0, 58). CA125 levels had significant positive correlation with creatinine D/P ratio (r=0, 34, p<0, 01). Alteration in CA125 value had significantly negative correlation with alteration in creatinine D/P ratio and PET transport status change (r=-0, 19, p<0, 05 and r=-0, 17, p<0, 05, respectively). CA125 had no correlation with ultrafiltration, daily glucose load, residual renal function and CRP values. Conclusions. The change of CA125 concentration in effluent is reversely proportional with change in creatinine D/P ratio and PET transport status. Mean CA125 value among patients tends to rise as well as overall creatinine D/P values during long-term PD. Further investigations on larger number of patients and longer periods of follow-up are needed.

Dialysate cancer antigen 125, peritoneal dialysis

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