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Peritoneal protein loss, inflammation, and nutrition: refuting myths

dc.contributor.authorMalho Guedes, A.
dc.contributor.authorCalças Marques, Roberto
dc.contributor.authorRibeiro, Brigitte
dc.contributor.authorFernandes, Mónica T.
dc.contributor.authorFaísca, Marília
dc.contributor.authorSilva, Ana Paula
dc.contributor.authorBragança, José
dc.contributor.authorRodrigues, Anabela
dc.date.accessioned2022-11-09T09:49:34Z
dc.date.available2022-11-09T09:49:34Z
dc.date.issued2022
dc.description.abstractPeritoneal protein loss (PPL) has been correlated with mortality, malnutrition and inflammation. More recently overhydration was brought to the equation. This study aims to review classic and recent factors associated with PPL. Prevalent and incident peritoneal dialysis (PD) patients were included. Dialysate and serum IL-6 was obtained during PET. Hydration and nutritional status were assessed by bio-impedance. Linear regression and Cox regression were performed. The 78 included patients presented median values of PPL 4.8 g/24 h, serum IL-6: 5.1 pg/mL, and IL-6 appearance rate 153.5 pg/min. Mean extracellular water excess (EWexc) was 0.88 ± 0.94 L, and lean body mass index (LBMI) 17.3 ± 2.4 kg/m2 . After mean follow-up of 33.9 ± 29.3 months, 12 patients died. Linear univariable analysis showed positive associations between PPL and small solute transport, body composition (LBMI and EWexc), comorbidities and performing CAPD (vs. cycler). PPL correlated positively with dialysate appearance rate of IL-6, but not with serum IL-6. Linear multivariable analysis confirmed positive association between PPL and EWexc (p = 0.012; 95%CI: 4.162–31.854), LBMI (p = 0.008; 95%CI: 1.720–11.219) and performing CAPD (p = 0.023; 95%CI: 4.375–54.190). In survival analysis, no relationship was found between mortality and PPL. Multivariable Cox regression showed Charlson Comorbidity Index (HR: 1.896, 95%CI: 1.235–2.913), overhydration (HR: 10.034, 95%CI: 1.426–70.587) and lower PPL (HR: 0.576, 95%CI: 0.339–0.978) were predictors for mortality. Overhydration, was a strong predictor of PPL, overpowering variables previously reported as determinants of PPL, namely clinical correlates of endothelial dysfunction or local inflammation. PPL were not associated with malnutrition or higher mortality, emphasizing the importance of volume overload control in PD patients.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.doi10.3389/fmed.2022.884061pt_PT
dc.identifier.eissn2296-858X
dc.identifier.urihttp://hdl.handle.net/10400.1/18480
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherFrontiers Mediapt_PT
dc.relationUnit for Multidisciplinary Research in Biomedicine
dc.relationUnit for Multidisciplinary Research in Biomedicine
dc.relationLaboratory for Integrative and Translational Research in Population Health
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectPeritoneal protein losspt_PT
dc.subjectPeritoneal dialysispt_PT
dc.subjectInflammationpt_PT
dc.subjectNutritionpt_PT
dc.subjectOverhydrationpt_PT
dc.titlePeritoneal protein loss, inflammation, and nutrition: refuting mythspt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.awardTitleUnit for Multidisciplinary Research in Biomedicine
oaire.awardTitleUnit for Multidisciplinary Research in Biomedicine
oaire.awardTitleLaboratory for Integrative and Translational Research in Population Health
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/UIDB%2F00215%2F2020/PT
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/UIDP%2F00215%2F2020/PT
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/LA%2FP%2F0064%2F2020/PT
oaire.citation.titleFrontiers in Medicinept_PT
oaire.citation.volume9pt_PT
oaire.fundingStream6817 - DCRRNI ID
oaire.fundingStream6817 - DCRRNI ID
oaire.fundingStream6817 - DCRRNI ID
person.familyNameMalho Guedes
person.familyNameBragança
person.familyNameRodrigues
person.givenNameAnabela
person.givenNameJosé
person.givenNameAnabela
person.identifierK-5226-2013
person.identifier.ciencia-idAC1D-FA9D-F66F
person.identifier.ciencia-id651F-A9D2-2136
person.identifier.orcid0000-0002-9627-908X
person.identifier.orcid0000-0001-9566-400X
person.identifier.orcid0000-0001-8818-2141
person.identifier.scopus-author-id37087078200
person.identifier.scopus-author-id6602220001
person.identifier.scopus-author-id7202269896
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.nameFundação para a Ciência e a Tecnologia
project.funder.nameFundação para a Ciência e a Tecnologia
project.funder.nameFundação para a Ciência e a Tecnologia
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication316db235-e120-46dc-8ec6-518d8ff314c2
relation.isAuthorOfPublication27334e02-e955-4939-b9b5-bdee5b5f9328
relation.isAuthorOfPublication38e0c95f-d31d-48f7-b3c8-25ae99f2a186
relation.isAuthorOfPublication.latestForDiscovery316db235-e120-46dc-8ec6-518d8ff314c2
relation.isProjectOfPublication23f88acf-6c29-4c4d-9321-9d0a491e644f
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relation.isProjectOfPublication69749040-5262-485a-a499-40fbd4d87651
relation.isProjectOfPublication.latestForDiscovery69749040-5262-485a-a499-40fbd4d87651

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