Proof-of-principle study to detect metabolic changes in peritoneal dialysis effluent in patients who develop encapsulating peritoneal sclerosis

Warwick B. Dunn, Angela Summers, Marie Brown, Royston Goodacre, Mark Lambie, Tim Johnson, Martin Wilkie, Simon Davies, Nick Topley, Paul Brenchley

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Background. Prolonged peritoneal dialysis (PD) therapy can result in the development of encapsulating peritoneal sclerosis (EPS), characterized by extensive sclerosis of the peritoneum with bowel adhesions often causing obstruction. Methods. As a proof-of-principle study, holistic profiling of endogenous metabolites has been applied in a prospective collection of PD effluent collected in multiple UK renal centres over 6 years in order to investigate metabolic differences in PD effluent between PD therapy patients who later developed clinically defined EPS (n = 11) and controls, who were matched for PD vintage, age and gender (n = 11). Results. 'Fit-for-purpose' analytical methods employing gas chromatography-mass spectrometry (MS), direct injection MS and quality control samples were developed and validated. These methods were applied in a proof-of-principle study to define metabolic differences in PD effluent related to subsequent development of EPS. Changes in amino acids, amines and derivatives, short-chain fatty acids and derivatives and sugars were observed prior to EPS developing, and changes in the metabolomic profiles could be detected. Conclusion. There is potential for applying metabolic profiles to identify patients at risk of developing EPS although long-term prospective studies with larger patient cohorts are required. © 2012 The Author.
    Original languageEnglish
    Pages (from-to)2502-2510
    Number of pages8
    JournalNephrology, Dialysis, Transplantation
    Volume27
    Issue number6
    DOIs
    Publication statusPublished - Jun 2012

    Keywords

    • EPS
    • GLOBAL fluid Study
    • Metabolomics

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