BACKGROUND: @entity298 ( @entity298 ) is now established as a viable and successful alternative to hemodialysis (HD) for @entity1 starting on renal replacement therapy. A number of studies have confirmed that equivalent adequacy and fluid balance are provided at least for the first four to five years of renal replacement therapy (RRT). Loss of peritoneal membrane function remains a major factor leading to treatment failure in a significant number of @entity1 on @entity298 . Numerous studies have suggested a relationship between these changes in function and structural changes in the membrane. A careful analysis of peritoneal biopsies from @entity298 @entity1 would allow the clear identification of those changes unique to @entity298 , in addition to indicating possible correlations with @entity413 exposure as well as other functional parameters. METHODS: We systematically examined peritoneal biopsies from 13 normal individuals, 29 uremic predialysis @entity1 , 55 HD @entity1 , and 157 @entity1 on long-term @entity298 . Well-oriented specimens were stained with @entity11979 and examined by a blinded pathologist. Limited clinical data has allowed a preliminary analysis of structure-function relationships. RESULTS: The median thickness of the submesothelial compact collagenous zone was 40 microm in normal individuals, 150 microm in uremic @entity1 , 150 microm in @entity1 on HD, and 2550 microm in @entity1 on @entity298 (P < 0.001 for all vs. normal individuals). Compact zone thickness increased significantly with duration of @entity298 therapy (0 to 24 months, 180 microm;>97 months, 600 microm). Vascular changes comprised progressive subendothelial hyalinization of postcapillary venules, with luminal narrowing or obliteration. These changes were present in uremic @entity1 and increased significantly with @entity298 duration (P = 0.0001). CONCLUSIONS: These data indicate that morphologic changes in the postcapillary venules and the submesothelial compact zone of @entity298 @entity1 begin during the uremic phase of their illness. This is then worsened by time spent on @entity298 . The relationships with @entity413 exposure or @entity413 degradation products have yet to be established.

XXXX : changes to the structure of the peritoneal membrane and potential for biocompatible solutions.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity413 :: ('MESH:D005947', 'Chemical') :: ['glucose'] @entity298 :: ('MESH:D010538', 'Disease') :: ['Peritoneal dialysis', 'PD'] @entity11979 :: ('MESH:D014048', 'Chemical') :: ['toluidine blue']
@entity298 :: (MESH:D010538,Disease) :: ['Peritoneal dialysis']
