Hypoalbuminaemia, systemic albumin leak and endothelial dysfunction in peritoneal dialysis patients
Nephrology Dialysis Transplantation, Exclusive Author Commentary

Yu Z et al. – This exploratory analysis indicates that endothelial barrier function is decreased in peritoneal dialysis patients and is associated with diabetic status and markers of platelet activation more than inflammation. In contrast, hypoalbuminaemia is associated more with inflammation and atherosclerotic disease indicating a more complex relationship between systemic endothelial barrier function, inflammation and hypoalbuminaemia.

In this study we wanted to explore the relationship between systemic protein leak, inflammation and endothelial dysfunction as hypoalbuminaema remains a significant problem in peritoneal dialysis patients. We confirmed previous findings that hypoalbuminaemia was associated with inflammation whereas the systemic protein leak was more associated with markers of platelet activation. The daily leak of albumin from the circulation far exceeds the losses from the peritoneal cavity but is presumably recirculated explaining why it has less impact on the plasma albumin concentration. To solve the problem of hypoalbuminaemia in PD patients - which contributes to their tissue oedema problems - it will be necessary to target the supression of albumin synthesis associated with inflammation.

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