The Relationship between PSTR and Alterations of Peritoneal Microvessels in PD Patients

As described earlier, many reports have been published with the theory that peritoneal transport is related to peritoneal vascular surface area; however, there is only one report, from the present authors, that investigated this phenomenon as the clinical fact. We reported alterations in the peritoneal capillary and postcapillary venule (i.e., the main part of water and solute transport; named "microvessel" in the report) in biopsy specimens of peritoneum obtained from PD patients.

The parietal peritoneal tissue was obtained from PD patients and stained by the modified Masson-Noguchi method (Figure 1) before using an image analysis program. The relative microvessels area (RVA, calculated as total area of microvessels/total area of peritoneal field) and relative microvessels number (RVN, calculated as number of microvessels/total area of peritoneal field) were determined

Figure 1 Human peritoneal membrane stained with Masson-Noguchi modified stain (original magnification 200x). (see color insert)

0.0 0.5 1.0 1.5 2.0 2.5 3.0 Relative microvessels area

Figure 2 Correlation between the relative microvessels area and D/P creatinine (rho = 0.77, p < 0.001, n = 22).

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Figure 3 Correlation between D/P creatinine and microvessel cross-section (RVA/RVN) (rho = 0.66, p = 0.003, n = 22).

for each specimen. The ratio RVA/RVN was used to assess the average area of microvessels. The D/P for creatinine showed a significant positive correlation with both RVA (Figure 2) and RVA/RVN (Figure 3), but not with RVN (Figure 4). This indicates that the dilatation of each perfused microvessel has an impact on PSTR. The D/P for b2 microglobulin (middle size molecule) correlated with RVA (Figure 5) with weaker correlation than the D/P for creati-

Relative microvessels number (/10 pix)

Figure 4 Relationship between D/P creatinine and relative microvessels number (rho = 0.02, p = NS, n = 22).

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Relative microvessels area (%)

Figure 6 Relationship between the relative microvessels area and D/P albumin (rho = -0.01, p = NS, n = 22).

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