Fibrosis of Peritoneal Membrane as Target of New Therapies in Peritoneal Dialysis
Valentina Masola, Mario Bonomini, Silvio Borrelli, Lorenzo Di Liberato, Luigi Vecchi, Maurizio Onisto, Giovanni Gambaro, Roberto Palumbo, Arduino Arduini
Abstract
Peritoneal dialysis (PD) is an efficient renal replacement therapy for patients with end-stage renal disease. Even if it ensures an outcome equivalent to hemodialysis and a better quality of life, in the long-term, PD is associated with the development of peritoneal fibrosis and the consequents patient morbidity and PD technique failure. This unfavorable effect is mostly due to the bio-incompatibility of PD solution (mainly based on high glucose concentration). In the present review, we described the mechanisms and the signaling pathway that governs peritoneal fibrosis, epithelial to mesenchymal transition of mesothelial cells, and angiogenesis. Lastly, we summarize the present and future strategies for developing more biocompatible PD solutions.