IES2025 Research, Audit and Quality Improvement Projects Physical Posters (55 abstracts)
Peritoneal dialysis is superior to haemodialysis in removal of steroid metabolites in end-stage kidney disease
Maria Tomkins 1,2 , Darran Mc Donald 1,2 , Merah Al-Busaidy 2 , Fozia Shaheen 3 , Angela E Taylor 3 , Abigail Armstrong 2 , Christina Martyn 2 , Amy Hudson 2 , Ciara N. Magee 2 , Declan de Freitas 2 , Mark Denton 2 , Peter Conlon 2 , Carol Traynor 2 , Colm Magee 2 , Conall O’Seaghdha 2 , Wiebke Arlt 3,4,5 , Michael W. O’Reilly 1,2 & Mark Sherlock 1,2
1Royal College of Surgeons in Ireland, Dublin; 2Beaumont Hospital, Dublin; 3Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK; 4Medical Research Council Laboratory of Medical Sciences, London, UK; 5Institute of Clinical Sciences, Imperial College London, London, UK
Impaired 11β-hydroxysteroid dehydrogenase type 2 activity in chronic kidney disease results in ineffective conversion of cortisol(F) to cortisone(E) which may result in glucocorticoid-mediated mineralocorticoid receptor activation. Previous reports have identified inefficient removal of glucocorticoid metabolites in haemodialysis (HD), however, glucocorticoid metabolism in peritoneal dialysis (PD) has not been studied. In this study, 30 patients (n = 15 HD, n = 15 PD) underwent multiple time-point sampling of serum and dialysate fluid during either a morning HD session or a peritoneal equilibrium test (PET). There were no statistical differences in age, sex or duration of HD session/PET (4 hour) between the groups. Samples were analysed using liquid chromatography–tandem mass spectrometry. At baseline, there were no significant differences in serum F (PD 362 nmol/lvs HD 339 nmol/l, P = 0.44) or E (PD 27 nmol/lvs HD 27 nmol/l, P = 0.81) between the two groups. During PET, the PD group showed significant reduction in serum F (362 nmol/lto 267 nmol/l, P = 0.01) with a corresponding increase in dialysate fluid F (3.1 nmol/lto 13.1 nmol/l, P < 0.0001) and E (1.5 nmol/lto 10.1 nmol/l, P < 0.0001). In contrast, patients undergoing HD did not exhibit significant changes in glucocorticoid concentrations in serum (F 339 nmol/lto 294 nmol/l, P = 0.2; E 0.03 nmol/lto 2.6 nmol/l, P = 0.08) or dialysate (F 0.08 nmol/lto 5.8 nmol/l, P = 0.4; E=0.03 nmol/lto 2.6 nmol/l, P = 0.08). These findings suggest that PD is more effective than HD in clearance of glucocorticoid metabolites, offering potential advantages in managing glucocorticoid metabolism in patients with end-stage renal disease.
Volume 115
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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