Table 1 Overview on peritoneal histomorphology in children with normal renal function and chronic kidney disease grade 5 and in children on peritoneal dialysis (PD) with PD fluids containing low and high concentrations of glucose degradation products (GDP). EMT epithelial-to-mesenchymal transition
Health | CKD G5 | Low GDP PD | High GDP PD |
|---|---|---|---|
Intact mesothelial monolayer | Mesothelium largely preserved | Reduced mesothelial cell coverage | More mesothelial cell loss compared to low GDP PD |
Three layers containing blood, lymphatic vessels, and nerves | Vessel density mildly increased | Major and diffuse increase in submesothelial vessel density within few months of PD | Less submesothelial angiogenesis |
Age-dependent vascularization and submesothelial thickness | Isolated submesothelial inflammatory cells, sparse EMT cells | Major submesothelial inflammatory cell invasion, inflammatory cytokines. Some EMT cells | Less submesothelial inflammatory cell invasion, less cytokine induction, but pronounced EMT |
Slow but steady increase in submesothelial fibrosis | More pronounced submesothelial fibrosis | ||
Moderate signs of vasculopathy | Dialytic glucose exposure-related vascular complement activation | Increased vascular AGE deposition, GDP exposure-related endothelial cell apoptosis, junction disruption, and endothelial cell loss. More lumen narrowing (intima thickening) |