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Peritoneal Cell-free DNA: an innovative method for determining acute cell damage in peritoneal membrane and for monitoring the recovery process after peritonitis

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Abstract

Background

Cell-free DNA (cfDNA) is present in the peritoneal effluent of stable peritoneal dialysis (PD) patients, but there are no data on cfDNA in PD patients with peritonitis. We investigated the variation of peritoneal cfDNA levels subsequent to peritonitis in PD patients.

Methods

We enrolled 53 PD patients: 30 without any history of systemic inflammation or peritonitis in the last 3 months (group A) and 23 with acute peritonitis (group B). CfDNA was quantified in the peritoneal effluent. Peritoneal samples on days 1, 3, 10, 30 and until day 120 from the start of peritonitis were collected for white blood cells (WBC) count and cfDNA evaluation in group B.

Results

Quantitative analysis of cfDNA showed significantly higher levels in group B on day 1, 3, 10 and 30 compared with group A (p < 0.05). A significant positive correlation was observed between cfDNA concentration and WBC on day 1 (rho = 0.89) and day 3 (rho = 0.5) (both, p < 0.05). However, no significant correlation was observed between cfDNA and WBC on days 10 and 30. In group B, peritoneal cfDNA levels tended to progressively decline during follow-up of peritonitis. From this decreasing curve, we estimated that 49 days are necessary to reach the value of 51 genome equivalents (GE)/ml (75th percentile in controls) and 63 days to reach 31 GE/ml (median).

Conclusion

Our results demonstrate that cfDNA increases in peritoneal effluent of PD patients with peritonitis and tends to progressively decline in step with peritonitis resolution and membrane repair process. Peritoneal cfDNA quantification could be an innovative method to determine acute damage and an inverse index of the repair process.

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Conflict of interest

No authors have reported a conflict of interest.

Ethical approval

This study was performed in accordance with the Declaration of Helsinki. The protocol and consent form were approved by the Ethics Committee of San Bortolo Hospital (Del.n.327, 8/2014).

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Authors and Affiliations

  1. IRRIV-International Renal Research Institute Vicenza, Vicenza, Italy

    Grazia Maria Virzì, Sabrina Milan Manani, Alessandra Brocca, Massimo de Cal, Silvia Pastori, Ilaria Tantillo, Carlo Crepaldi & Claudio Ronco

  2. Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Via Rodolfi, 37 - 36100, Vicenza, Italy

    Grazia Maria Virzì, Sabrina Milan Manani, Alessandra Brocca, Massimo de Cal, Silvia Pastori, Ilaria Tantillo, Roberto Zambon, Carlo Crepaldi & Claudio Ronco

  3. Department of Medicine DIMED, University of Padua Medical School, Padua, Italy

    Alessandra Brocca

  4. Nephrology, Dialysis and Kidney Transplantation Unit, Department of Medical Sciences, Azienda Ospedaliera “Città della Salute e della Scienza di Torino- Presidio Molinette”, University of Turin, Turin, Italy

    Vincenzo Cantaluppi

  5. Department of Information Engineering, University of Padua, Padua, Italy

    Silvia Pastori

Authors
  1. Grazia Maria Virzì
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  2. Sabrina Milan Manani
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  3. Alessandra Brocca
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  4. Vincenzo Cantaluppi
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  5. Massimo de Cal
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  6. Silvia Pastori
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  7. Ilaria Tantillo
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  8. Roberto Zambon
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  9. Carlo Crepaldi
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  10. Claudio Ronco
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Corresponding author

Correspondence to Grazia Maria Virzì.

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Virzì, G.M., Milan Manani, S., Brocca, A. et al. Peritoneal Cell-free DNA: an innovative method for determining acute cell damage in peritoneal membrane and for monitoring the recovery process after peritonitis. J Nephrol 29, 111–118 (2016). https://doi.org/10.1007/s40620-015-0212-2

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  • DOI: https://doi.org/10.1007/s40620-015-0212-2

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