Autori: Grazia Maria Virzì, Carlo Crepaldi, Sabrina Milan Manani, Anna Giuliani and Claudio Ronco
Affiliazioni: Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Vicenza, Italy and IRRIV-International Renal Resarch Institute Vicenza, Italy
Previous studies demonstrated that LPS is common in PD patients, in particular, its level is related to the degree of systemic inflammation. In this study, we evaluated LPS levels in PD patients with Gram-positive (GP) and GN peritonitis.
We enrolled 49 patients: 37 with peritonitis and 12 without. Peritoneal samples were collected for peritoneal WBC count (pWBC) and LPS, plasma samples for WBC count, LPS, CRP and IL6, IL1β, IL8 on the first day of peritonitis.
Peritoneal and plasma LPS levels were higher in patients with peritonitis compared to patients without (p=0.001). We divided patients with peritonitis in 2 groups according to Gram(GP: 27; GN: 14). Peritoneal and plasma LPS levels showed significantly lower levels in GP peritonitis than in GN (p=0.001). The median level of LPS showed no significant differences between patients without peritonitis and with GP peritonitis (p=0.195). On the contrary, LPS levels showed significantly higher levels in PD patients with GN peritonitis compared to patients without peritonitis (p=0.001). A significant positive correlation was observed between pWBC and peritoneal LPS (Spearman’s rho=0.412, p=0.013). However, no statistically significant correlation was observed between plasma LPS and WBC count, CRP, IL6, IL1 and IL8 levels.
We observed LPS presence in all PD patients, pWBC and LPS levels increased proportionally in PD patients with peritonitis and LPS is significantly elevated in GN peritonitis. We concluded that peritoneal and plasma LPS could be a useful marker for diagnosis and management of GN peritonitis in PD patients.
