Author/Editor		Dobbie, JW; Anderson, JD
Title		The peritoneal memebrane in CAPD: information from the peritoneal biopsy registry
Type		članek
Source		In: Lindič J, Kaplan-Pavlovčič S, editors. Zbornik prispevkov 1. slovenski nefrološki kongres z mednarodno udeležbo; 1996 okt 23-26; Portorož. Ljubljana: Klinični center, Nefrološka klinika,
Publication year		2000
Volume		str. 233-9
Language		eng
Abstract		When CAPD was introduced in the late 1970s there had been few studies on the morphology and ultrastructure of the peritoneum. Patients then came to rely on a dialysing membrane whose basic biology was largely unknown, while an ignorance of the histopathology of the peritoneum raised concerns over our ability to recognise subtle changes caused by peritoneal dialysis. In 1978 a biopsy registry was set up initially in Scotland to rectify this deficiency in our knowledge through examination by light, transmission and scanning electron microscopy, samples of parietal peritoneum from normal individuals and uraemic patients before, during and after peritoneal dialysis. With the development of CAPD the registry became an international registry receiving biopsies from dialysis units throughout the world. Electron microscopy of human peritoneal mesothelium revealed a cell of considerable ultrastructural complexity typical of a secretory rather than a simple lining cell. Specialised techniques developed for studying lung when applied to mesothelium demonstrated lamellated, densely osmiophilic organelles subsequently shown to be identical to lamellar bodies found in Type II pneumocytes, which are storage bodies for pulmonary surfactant. Biopsies of uraemic peritoneum prior to the onset of CAPD have revealed paracrystalline filamentous intramesothelial cytoplasmic inclusions which are probably the cause of mesothelial exfoliation in uraemic serositis. Following exposure to dialysate, the mesothelium exhibits reactive changes in cluding increased number of cells per unit area, decreased density of both surface microvilli and micropinocytotic vesicles, and a hyperplasia of the rough endoplasmic reticulum. With increasing time of CAPD, biopsies show reduplication of the basement membrane of both mesothelium and the microvasculature of the submesothelial stroma. (Abstract truncated at 2000 characters.)
Descriptors		PERITONEAL DIALYSIS, CONTINUOUS AMBULATORY PERITONEUM BIOPSY UREMIA MICROSCOPY, ELECTRON PERITONITIS