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Endotoxemia in peritoneal dialysis patients: a pilot study to examine the role of intestinal perfusion and congestion

Grant, Claire; Harrison, Laura; Hoad, Caroline; Marciani, Luca; Cox, Eleanor; Buchanan, Charlotte; Costigan, Carolyn; Francis, Susan; Lai, Ka-Bik; Szeto, Cheuk-Chun; Gowland, Penny; McIntyre, Christopher

Authors

Claire Grant

Laura Harrison

CAROLINE HOAD CAROLINE.L.HOAD@NOTTINGHAM.AC.UK
Senior Research Fellow

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LUCA MARCIANI LUCA.MARCIANI@NOTTINGHAM.AC.UK
Professor of Gastrointestinal Imaging

ELEANOR COX ELEANOR.COX@NOTTINGHAM.AC.UK
Senior Research Fellow

Carolyn Costigan

Ka-Bik Lai

Cheuk-Chun Szeto

Christopher McIntyre



Abstract

Endotoxemia is common in advanced chronic kidney disease and is particularly severe in those receiving dialysis. In hemodialysis patients, translocation from the bowel occurs as a consequence of recurrent circulatory stress leading to a reduction in circulating splanchnic volume and increased intestinal permeability. Peritoneal dialysis (PD) patients are often volume expanded and have continuous direct immersion of bowel in fluid; these may also be important factors in endotoxin translocation and would suggest different therapeutic strategies to improve it. The mechanisms leading to endotoxemia have never been specifically studied in PD. In this study, 17 subjects (8 PD patients, 9 healthy controls) underwent detailed gastrointestinal and cardiac magnetic resonance imaging during fasted and fed states. Gross splanchnic perfusion was assessed by quantification of superior mesenteric artery flow. Magnetic resonance imaging findings were correlated to endotoxemia, markers of hydration status and cardiac structure and function.

Citation

Grant, C., Harrison, L., Hoad, C., Marciani, L., Cox, E., Buchanan, C., …McIntyre, C. (2017). Endotoxemia in peritoneal dialysis patients: a pilot study to examine the role of intestinal perfusion and congestion. Peritoneal Dialysis International, 37(1), 111-115. https://doi.org/10.3747/pdi.2016.00079

Journal Article Type Article
Acceptance Date Feb 2, 2017
Online Publication Date Feb 2, 2017
Publication Date Feb 28, 2017
Deposit Date Dec 13, 2018
Journal Peritoneal Dialysis International
Print ISSN 0896-8608
Electronic ISSN 1718-4304
Peer Reviewed Peer Reviewed
Volume 37
Issue 1
Pages 111-115
DOI https://doi.org/10.3747/pdi.2016.00079
Public URL https://nottingham-repository.worktribe.com/output/1412177
Publisher URL http://www.pdiconnect.com/content/37/1/111