Peritoneal protein losses in children with steroid-resistant nephrotic syndrome on continuous-cycler peritoneal dialysis

Sashikala Kopanati, Michel G Baum, Albert Quan

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Glomerular protein permeability rises in nephrotic syndrome and may result from the effect of an unidentified "circulating factor." The effect of this "circulating factor" on the permeability of other body membranes is unknown. In this study we examine the peritoneal membrane protein permeability in patients with nephrotic syndrome on chronic-cycler peritoneal dialysis. We conducted a retrospective study of peritoneal protein losses in the dialysate effluent of 60 pediatric peritoneal dialysis patients (ages 5.1-22 years) over a 6-year period (January 1997-December 2002). Nineteen patients had steroid-resistant nephrotic syndrome (SRNS), while 41 had other non-nephrotic etiologies of renal failure. Total and normalized peritoneal protein losses are higher in SRNS than in non-nephrotic patients (12,603±5,403 mg/day vs 4,475±469 mg/day, P<0.05; 297.8±79.3 mg/kg per day vs 156.8±16.0 mg/kg per day, P<0.05; 9,614.6±3,253.4 mg/ m2 per day vs 4,168.3±367.3 mg/m2 per day, P<0.05). The ratio of total protein in dialysate to plasma, a measure of peritoneal membrane protein permeability, was higher in SRNS patients (3.50±1.00% vs 0.68±0.06%, P<0.001). Serum albumin concentration was lower in SRNS patients (3.09±0.13 mg/dl vs 3.52±0.07 mg/dl, P<0.01). There were no differences between the two groups with regard to duration of peritoneal dialysis, dialysis prescription, numbers of peritonitis episodes, catheter replacements, or hospitalizations. In summary, these results demonstrate that peritoneal protein losses in patients with SRNS are twice as great as in those without nephrotic syndrome. These results are consistent with the systemic effect of a "circulating factor" in SRNS and underscore the importance of adequate protein intake in patients on peritoneal dialysis.

Original languageEnglish (US)
Pages (from-to)1013-1019
Number of pages7
JournalPediatric Nephrology
Volume21
Issue number7
DOIs
StatePublished - Jul 1 2006

Fingerprint

Nephrotic Syndrome
Peritoneal Dialysis
Steroids
Proteins
Permeability
Dialysis Solutions
Membrane Proteins
Peritonitis
Serum Albumin
Renal Insufficiency
Prescriptions
Dialysis
Hospitalization
Catheters
Retrospective Studies
Pediatrics
Membranes

Keywords

  • Focal segmental glomerulosclerosis
  • Glomerular permeability
  • Peritoneal membrane
  • Steroid-resistant nephrotic syndrome

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

Cite this

Peritoneal protein losses in children with steroid-resistant nephrotic syndrome on continuous-cycler peritoneal dialysis. / Kopanati, Sashikala; Baum, Michel G; Quan, Albert.

In: Pediatric Nephrology, Vol. 21, No. 7, 01.07.2006, p. 1013-1019.

Research output: Contribution to journalArticle

@article{68799e6bbece41fd8fb7a9bb7c416809,
title = "Peritoneal protein losses in children with steroid-resistant nephrotic syndrome on continuous-cycler peritoneal dialysis",
abstract = "Glomerular protein permeability rises in nephrotic syndrome and may result from the effect of an unidentified {"}circulating factor.{"} The effect of this {"}circulating factor{"} on the permeability of other body membranes is unknown. In this study we examine the peritoneal membrane protein permeability in patients with nephrotic syndrome on chronic-cycler peritoneal dialysis. We conducted a retrospective study of peritoneal protein losses in the dialysate effluent of 60 pediatric peritoneal dialysis patients (ages 5.1-22 years) over a 6-year period (January 1997-December 2002). Nineteen patients had steroid-resistant nephrotic syndrome (SRNS), while 41 had other non-nephrotic etiologies of renal failure. Total and normalized peritoneal protein losses are higher in SRNS than in non-nephrotic patients (12,603±5,403 mg/day vs 4,475±469 mg/day, P<0.05; 297.8±79.3 mg/kg per day vs 156.8±16.0 mg/kg per day, P<0.05; 9,614.6±3,253.4 mg/ m2 per day vs 4,168.3±367.3 mg/m2 per day, P<0.05). The ratio of total protein in dialysate to plasma, a measure of peritoneal membrane protein permeability, was higher in SRNS patients (3.50±1.00{\%} vs 0.68±0.06{\%}, P<0.001). Serum albumin concentration was lower in SRNS patients (3.09±0.13 mg/dl vs 3.52±0.07 mg/dl, P<0.01). There were no differences between the two groups with regard to duration of peritoneal dialysis, dialysis prescription, numbers of peritonitis episodes, catheter replacements, or hospitalizations. In summary, these results demonstrate that peritoneal protein losses in patients with SRNS are twice as great as in those without nephrotic syndrome. These results are consistent with the systemic effect of a {"}circulating factor{"} in SRNS and underscore the importance of adequate protein intake in patients on peritoneal dialysis.",
keywords = "Focal segmental glomerulosclerosis, Glomerular permeability, Peritoneal membrane, Steroid-resistant nephrotic syndrome",
author = "Sashikala Kopanati and Baum, {Michel G} and Albert Quan",
year = "2006",
month = "7",
day = "1",
doi = "10.1007/s00467-006-0012-y",
language = "English (US)",
volume = "21",
pages = "1013--1019",
journal = "Pediatric Nephrology",
issn = "0931-041X",
publisher = "Springer Verlag",
number = "7",

}

TY - JOUR

T1 - Peritoneal protein losses in children with steroid-resistant nephrotic syndrome on continuous-cycler peritoneal dialysis

AU - Kopanati, Sashikala

AU - Baum, Michel G

AU - Quan, Albert

PY - 2006/7/1

Y1 - 2006/7/1

N2 - Glomerular protein permeability rises in nephrotic syndrome and may result from the effect of an unidentified "circulating factor." The effect of this "circulating factor" on the permeability of other body membranes is unknown. In this study we examine the peritoneal membrane protein permeability in patients with nephrotic syndrome on chronic-cycler peritoneal dialysis. We conducted a retrospective study of peritoneal protein losses in the dialysate effluent of 60 pediatric peritoneal dialysis patients (ages 5.1-22 years) over a 6-year period (January 1997-December 2002). Nineteen patients had steroid-resistant nephrotic syndrome (SRNS), while 41 had other non-nephrotic etiologies of renal failure. Total and normalized peritoneal protein losses are higher in SRNS than in non-nephrotic patients (12,603±5,403 mg/day vs 4,475±469 mg/day, P<0.05; 297.8±79.3 mg/kg per day vs 156.8±16.0 mg/kg per day, P<0.05; 9,614.6±3,253.4 mg/ m2 per day vs 4,168.3±367.3 mg/m2 per day, P<0.05). The ratio of total protein in dialysate to plasma, a measure of peritoneal membrane protein permeability, was higher in SRNS patients (3.50±1.00% vs 0.68±0.06%, P<0.001). Serum albumin concentration was lower in SRNS patients (3.09±0.13 mg/dl vs 3.52±0.07 mg/dl, P<0.01). There were no differences between the two groups with regard to duration of peritoneal dialysis, dialysis prescription, numbers of peritonitis episodes, catheter replacements, or hospitalizations. In summary, these results demonstrate that peritoneal protein losses in patients with SRNS are twice as great as in those without nephrotic syndrome. These results are consistent with the systemic effect of a "circulating factor" in SRNS and underscore the importance of adequate protein intake in patients on peritoneal dialysis.

AB - Glomerular protein permeability rises in nephrotic syndrome and may result from the effect of an unidentified "circulating factor." The effect of this "circulating factor" on the permeability of other body membranes is unknown. In this study we examine the peritoneal membrane protein permeability in patients with nephrotic syndrome on chronic-cycler peritoneal dialysis. We conducted a retrospective study of peritoneal protein losses in the dialysate effluent of 60 pediatric peritoneal dialysis patients (ages 5.1-22 years) over a 6-year period (January 1997-December 2002). Nineteen patients had steroid-resistant nephrotic syndrome (SRNS), while 41 had other non-nephrotic etiologies of renal failure. Total and normalized peritoneal protein losses are higher in SRNS than in non-nephrotic patients (12,603±5,403 mg/day vs 4,475±469 mg/day, P<0.05; 297.8±79.3 mg/kg per day vs 156.8±16.0 mg/kg per day, P<0.05; 9,614.6±3,253.4 mg/ m2 per day vs 4,168.3±367.3 mg/m2 per day, P<0.05). The ratio of total protein in dialysate to plasma, a measure of peritoneal membrane protein permeability, was higher in SRNS patients (3.50±1.00% vs 0.68±0.06%, P<0.001). Serum albumin concentration was lower in SRNS patients (3.09±0.13 mg/dl vs 3.52±0.07 mg/dl, P<0.01). There were no differences between the two groups with regard to duration of peritoneal dialysis, dialysis prescription, numbers of peritonitis episodes, catheter replacements, or hospitalizations. In summary, these results demonstrate that peritoneal protein losses in patients with SRNS are twice as great as in those without nephrotic syndrome. These results are consistent with the systemic effect of a "circulating factor" in SRNS and underscore the importance of adequate protein intake in patients on peritoneal dialysis.

KW - Focal segmental glomerulosclerosis

KW - Glomerular permeability

KW - Peritoneal membrane

KW - Steroid-resistant nephrotic syndrome

UR - http://www.scopus.com/inward/record.url?scp=33745089167&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33745089167&partnerID=8YFLogxK

U2 - 10.1007/s00467-006-0012-y

DO - 10.1007/s00467-006-0012-y

M3 - Article

VL - 21

SP - 1013

EP - 1019

JO - Pediatric Nephrology

JF - Pediatric Nephrology

SN - 0931-041X

IS - 7

ER -