Participant flow diagram depicting the screening/enrollment process.

<p>Participant flow diagram depicting the screening/enrollment process.</p

Bacteriology.

<p>Abbreviations: GNB, gram-negative bacillus; GPC, gram-positive cocci.</p><p>chi-square test.</p><p><i>*p</i><0.05.</p><p>Bacteriology.</p

Blood glucose levels and renal outcome.

<p>Abbreviation: SD, standard deviation.</p><p><i>*p</i><0.05.</p><p>Blood glucose levels and renal outcome.</p

Cox proportional hazard regression: hazard ratio of variables and renal injury.

<p><i>*p<0.05.</i></p><p>Cox proportional hazard regression: hazard ratio of variables and renal injury.</p

Glucose variability: standard deviation (SD) and renal outcome.

<p><i>*p</i><0.05.</p><p>Glucose variability: standard deviation (SD) and renal outcome.</p

Glucose variability: coefficient of variation (CV) and renal outcome.

<p><i>*p<0.05.</i></p><p>Glucose variability: coefficient of variation (CV) and renal outcome.</p

Patient characteristics.

<p>Abbreviations: CVD, cardiovascular disease; ALT, alanine aminotransferase; WBC, white blood cell; UPCR, urine protein–creatinine ratio; SBP, systolic blood pressure; DBP, diastolic blood pressure.</p>†<p>chi-square test.</p>‡<p>student's t-test.</p>§<p>Mann–Whitney U test.</p><p><i>*p</i><0.05.</p><p>Patient characteristics.</p

Changes in estimated glomerular filtration rate (eGFR) over time within the early- and late-recovery groups.

<p>T (0) represents the time point on admission from urinary tract infection; the “plus” and “minus” symbols represent the time interval after and before admission, respectively. Acute kidney injury occurred in diabetic patients with chronic kidney disease [eGFR at T (0) versus T (−6); <i>p</i> = 0.007 in Group A; <i>p</i> = 0.001 in Group B], and eGFR reverted to the trend 6 months later if urinary tract infection was cured.</p

Associations between the Duration of Dialysis, Endotoxemia, Monocyte Chemoattractant Protein-1, and the Effects of a Short-Dwell Exchange in Patients Requiring Continuous Ambulatory Peritoneal Dialysis

<div><p>Background</p><p>Endotoxemia is exaggerated and contributes to systemic inflammation and atherosclerosis in patients requiring continuous ambulatory peritoneal dialysis (CAPD). The risk of mortality is substantially increased in patients requiring CAPD for >2 years. However, little is known about the effects of long-term CAPD on circulating endotoxin and cytokine levels. Therefore, the present study evaluated the associations between plasma endotoxin levels, cytokine levels, and clinical parameters with the effects of a short-dwell exchange on endotoxemia and cytokine levels in patients on long-term CAPD.</p><p>Methods</p><p>A total of 26 patients were enrolled and divided into two groups (short-term or long-term CAPD) according to the 2-year duration of CAPD. Plasma endotoxin and cytokine levels were measured before and after a short-dwell exchange (4-h dwell) during a peritoneal equilibration test (a standardized method to evaluate the solute transport function of peritoneal membrane). These data were analyzed to determine the relationship of circulating endotoxemia, cytokines and clinical characteristics between the two groups.</p><p>Results</p><p>Plasma endotoxin and monocyte chemotactic protein-1 (MCP-1) levels were significantly elevated in the long-term group. PD duration was significantly correlated with plasma endotoxin (<i>r</i> = 0.479, <i>P</i> = 0.016) and MCP-1 (<i>r</i> = 0.486, <i>P</i> = 0.012). PD duration was also independently associated with plasma MCP-1 levels in multivariate regression. Plasma MCP-1 levels tended to decrease (13.3% reduction, <i>P</i> = 0.077) though endotoxin levels did not decrease in the long-term PD group after the 4-h short-dwell exchange.</p><p>Conclusion</p><p>Long-term PD may result in exaggerated endotoxemia and elevated plasma MCP-1 levels. The duration of PD was significantly correlated with circulating endotoxin and MCP-1 levels, and was an independent predictor of plasma MCP-1 levels. Short-dwell exchange seemed to have favorable effects on circulating MCP-1 levels in patients on long-term PD.</p></div

Comparison of circulating endotoxin and cytokine levels after a 4-h exchange between the short- and long-term PD groups.

<p>Values are median (interquartile range) or means±standard error of the mean.</p><p>% change, percentage change; GM-CSF, granulocyte-macrophage colony-stimulating factor; IFN-γ, interferon-γ; IL, interleukin; IL-1RA, interleukin-1 receptor antagonist; MCP-1, monocyte chemoattractant protein-1; TNF, tumor necrosis factor.</p><p>Comparison of circulating endotoxin and cytokine levels after a 4-h exchange between the short- and long-term PD groups.</p