SAGE-Hindawi Access to Research International Journal of Nephrology Volume 2011, Article ID 261040, 5 pages doi:10.4061/2011/261040 Clinical Study Efﬂuent Markers Related to Epithelial Mesenchymal Transition with Adjusted Values for Efﬂuent Cancer Antigen 125 in Peritoneal Dialysis Patients Sonoo Mizuiri,1 Hiromichi Hemmi,2 Michitsune Arita,2 Reibin Tai,1 Yoshinari Hattori,1 Atsuhiko Muto,1 Yasunori Suzuki,1 Yasushi Ohashi,1 Ken Sakai,1 and Atsushi Aikawa1 1 Department of Nephrology, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ohta-ku, Tokyo 143-8541, Japan 2 Department of Molecular Biology, Toho University School of Medicine, Tokyo 143-8541, Japan Correspondence should be addressed to Sonoo Mizuiri, sm210@med.toho-u.ac.jp Received 27 January 2011; Accepted 26 April 2011 Academic Editor: Hulya Taskapan Copyright © 2011 Sonoo Mizuiri et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objectives. Epithelial mesenchymal transition (EMT) is important for peritoneal deterioration. We evaluated the association between peritoneal solute transport rate (PSTR) and eﬄuent markers related to EMT with adjusted values for eﬄuent cancer antigen 125 (CA125). Methods. One hundred ﬁve incident peritoneal dialysis (PD) patients on PD for 25 (12–68) months with biocompatible solutions were included in the study. Fast peritoneal equilibration test was used to evaluate PSTR. Eﬄuent hepatocyte growth factor (HGF), bone morphogenic protein-7 (BMP-7), vascular endothelial growth factor (VEGF), interleukin- 6 (IL-6), and CA125 at 4 h were measured. Results. Patients with dialysate/plasma creatinine 0.82 showed signiﬁcantly higher eﬄuent HGF (240 versus 133 pg/mL, P < .001), VEGF, IL-6, and IL6/CA125 levels than the others but no signiﬁcant diﬀerences in eﬄuent HGF/CA125, BMP-7, and BMP7/CA125 were observed. Conclusion. Increase in the eﬄuent HGF levels as a compensatory mechanism is a marker of peritoneal deterioration, but controversy remains regarding adjusted value for CA125. 1. Introduction Resident ﬁbroblasts and inﬁltrating inﬂammatory cells are considered to be the main entities responsible for structural and functional alterations in the peritoneum, but recent ﬁnd- ings have demonstrated that new ﬁbroblastic cells can arise from the local conversion of mesothelial cells by epithelial- to-mesenchymal transition (EMT) during the inﬂamma- tory and repair responses that are induced by peritoneal dialysis (PD) [1]. EMT of peritoneal mesothelial cells is associated with angiogenic stimuli and altered transport through common initiating growth factors and inﬂamma- tory cytokines [2, 3]. Hepatocyte growth factor (HGF) and bone morphogenic protein-7 (BMP-7) ameliorate high- glucose-induced EMT of the peritoneal mesothelium [4, 5]. As it is not possible to perform repeated peritoneal biop- sies, the search for eﬄuent markers of peritoneal damage and EMT is clinically important. However, the clinical signiﬁ- cance of HGF and BMP-7 eﬄuent levels with regard to these conditions remains unclear. It has also been reported that dialysate growth factor levels should be measured relative to the mesothelial cell mass, for example, relative to the level of cancer antigen 125 (CA125) [6, 7]. We evaluated the association between peritoneal membrane transport rate and the expression of eﬄuent markers related to epithelial mesenchymal transition (HGF, BMP-7, vascular endothelial growth factor (VEGF), and interleukin-6 (IL-6)) with adjust- ing the levels of these markers relative to the eﬄuent CA125 concentration in patients on PD. 2. Subjects and Methods 2.1. Patient Selection. From December 2007 to December 2010, all incident PD patients, aged between 20 and 69, who were being treated at our unit were enrolled in the study (n = 116). The patients had been on continuous ambulatory peritoneal dialysis (CAPD) with dual-chamber bags, neutral- pH, and low-GDP glucose-based solutions for more than