Open Access Medical Books



Edited by Abelardo Aguilera Peralta .

Open Access .
114 pages .
ISBN 978-953-51-1164-1 .

The peritoneal dialysis (PD) is a kidney replacement therapy technique that has been growing in the last years. One reason for this growth is the freedom that the PD technique provides patients allowing them a better social development. However, parallel to the increase in frequency, it also increased its complications.
Cardiovascular and infectious diseases, malnutrition and peritoneal damage arising from inherent to PD process itself are still the leading causes of morbidity and mortality. Recently, there have been many advances in the understanding of the complications associated with PD and uremic state that suggests that the peritoneal cavity is a victim of the attacks produced by bioincompatible liquids, plastics, hemoperitoneum and infections and see victimizer because activation of this cavity acts as a true organ releasing substances with systemic effects. These substances could induce systemic effects as inflammation, dyslipidemia, diabetes, hypertension, accelerated atherosclerosis and malnutrition. Effectively, the hyperproduction and renal retention of pro-inflammatory cytokines is key for the initiation and maintenance of accelerated atherosclerosis, loss of renal function, bone renal diseases, protein malnutrition and other uremic complications. Furthermore, local effects of PD liquids that activate the immune system, the abdominal fat tissue, which is bathed by these PD liquids, the mesothelial cells and the other components of the abdominal cavity, induce deterioration of the peritoneal membrane reaching anatomical and functional failure. Although considerable efforts to improve the biocompatibility of PD fluid has been made in the last years. It should be noted also that the changes undergone in the peritoneal and mesothelial-to-mesenchymal transition (MMT) offer new and novel therapeutic opportunities. MMT is regularly triggered by the action of glucose degradation products, low pH of the PD fluids, and other advance glycation end-products formation.
These transdifferentiated mesothelial cells acquire migratory capacity, invade the submesotelio where they produce high quantity of extracellular matrix components and high number of sanguineous and lymphatic vessels (angiogenesis and lymphangiogenesis).
This book provides an update on the emerging concepts in relation to new substances and mechanisms implicated in PD complications and attempts to organize the puzzle of these potentially active molecules. The authors have made a significant effort to update and summarize the relevance of each topic and especially to sort, in a logical and understandable way, the information provided here. New therapeutic strategies are proposed.

Dr. Abelardo Aguilera Peralta (MD, Ph.D),
specialty in Nephrology,
senior researcher (Miguel Servet Program)
at Instituto de Investigación Sanitaria 
del Hospital Universitaria de la Princesa,
Madrid, Spain


I The Peritoneal Catheter in Peritoneal Dialysis .

 1 Peritoneal Dialysis Catheter Placement and Management 3 Zhen Su

II Peritoneal Membrane Complication in Peritoneal Dialysis .

 2 The Mesothelial to Mesenchymal Transition a Pathogenic and Therapeutic Key for Peritoneal Membrane Failure 21 Abelardo Aguilera, Jesús Loureiro, Guadalupe Gónzalez-Mateo, Rafael Selgas and Manuel López-Cabrera

 3 Encapsulating Peritoneal Sclerosis 39 Joerg Latus, Christoph Ulmer, Martin Kimmel, M. Dominik Alscher and Niko Braun

III Systemic Complications Associated to Peritoneal Dialysis .

 4 Inflammation in Peritoneal Dialysis 55 Joseph C.K. Leung, Loretta Y. Y. Chan, Kar Neng Lai and Sydney C.W. Tang

 5 The Association with Cardiovascular Events and Residual Renal Function in Peritoneal Dialysis 83 Betül Kalender and Necmi Eren .

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Published by: Unknown - Saturday, June 22, 2013


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