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Plasminogen activator inhibitor-1 and peritoneal transport in peritoneal dialysis patients.

Plasminogen activator inhibitor-1 (PAI-1) is involved in the accumulation of extracellular matrix in various tissues. Since peritoneal interstitium is one of the resistance sites for transport during peritoneal dialysis (PD), the peritoneal PAI-1 level may have a significant effect on peritoneal transport. It was the purpose of this study to examine the associations between plasma or dialysate PAI-1 levels and the variables of peritoneal transport during peritoneal equilibration tests (PET) in 25 stable, adult PD patients. The dialysate PAI-1 levels increased with dwell time. Hematocrit was a positive predictor of plasma PAI-1 concentration and the change of dialysate PAI-1 amount scaled by body surface area (delta DPAI/ BSA). The peritoneal clearance of PAI-1 was higher than expected for its molecular size, suggesting a local production of PAI-1 in peritoneal tissue. The mass transfer coefficient of creatinine scaled by BSA (MTCcr/BSA) was a positive predictor of delta D PAI/BSA, suggesting the diffusion of plasma PAI-1 into the peritoneal cavity also accounted for part of the increased dialysate PAI-1 levels during PET. delta DPAI/BSA was a positive predictor of MTC of urea (ur) MTCwr/BSA and MTCcr/BSA, parameters for diffusive transport. Our findings are consistent with the hypothesis that peritoneal PAI-1 level has a significant effect on peritoneal transport during PD.