Mesothelial impairment induced by peritoneal dialysis and its potential protective strategies_Journal of Biomedical Engineering

Authors：

BAN Yu ¹ , MEI Yingying ¹ , CHEN Botao ¹ ,  TANG Wen ² ,  KANG Hongyan ¹

1. Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Key Laboratory of Ministry of Industry and Information Technology for High-end Medical Equipment and Instruments Innovation and Transformation, National Medical Innovation (Medicine-Engineering Integration) High-end Medical Equipment and Instruments Industry-Education Integration Innovation Platform, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, P. R. China;
2. Department of Nephrology, Peking University Third Hospital, Beijing 100191, P. R. China;

Corresponding?author：

Keywords：

Peritoneal dialysis; High-glucose peritoneal dialysis solutions; Mesothelial cell; Glycocalyx

DOI：

10.7507/1001-5515.202511048

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Peritoneal dialysis serves as a critical treatment modality for end-stage renal disease. Extensive clinical practice has demonstrated that long-term exposure to high-glucose non-physiological peritoneal dialysis solutions can induce peritoneal injury, which is directly associated with a decline in ultrafiltration function and solute clearance capacity. This represents a significant cause of technical failure in dialysis and adverse clinical outcomes, such as peritonitis. Mesothelial cells and the glycocalyx on their surface, acting as the direct barrier between the peritoneum and the dialysis solution, play essential roles in regulating multiple pathophysiological processes, including fibrosis and inflammation, and are crucial for maintaining peritoneal function. This review provides a brief introduction to mesothelial cells and the glycocalyx, with a focus on elucidating the injury to the mesothelium and glycocalyx caused by high-glucose non-physiological peritoneal dialysis solutions, the associated injury mechanisms, and potential protective strategies. The aim is to offer insights for developing novel therapeutic approaches to preserve the structural and functional integrity of the peritoneum and extend the survival of patients undergoing peritoneal dialysis.

Citation： BAN Yu, MEI Yingying, CHEN Botao, TANG Wen, KANG Hongyan. Mesothelial impairment induced by peritoneal dialysis and its potential protective strategies. Journal of Biomedical Engineering, 2026, 43(2): 398-404. doi: 10.7507/1001-5515.202511048 Copy

1.	Seghers F, Tintillier M, Morelle J. Recent advances in the understanding of the peritoneal membrane. Curr Opin Nephrol Hypertens, 2025, 34(1): 77-84.
2.	Prasad N, Chaturvedi S, Singh H, et al. Peritoneal dialysis-associated fibrosis: emerging mechanisms and therapeutic opportunities. Front Pharmacol, 2025, 16: 1635624.
3.	Parolin M, Ceschia G, Bertazza Partigiani N, et al. Non-infectious complications of peritoneal dialysis in children. Pediatr Nephrol, 2025, 40(10): 3055-3066.
4.	Evanko S P, Tammi M I, Tammi R H, et al. Hyaluronan-dependent pericellular matrix. Adv Drug Deliv Rev, 2007, 59(13): 1351-1365.
5.	Gaballah A H, Algazzar M, Kazi I A, et al. The peritoneum: anatomy, pathologic findings, and patterns of disease spread. Radiographics, 2024, 44(8): e230216.
6.	Marinovic I, Bartosova M, Levai E, et al. Molecular and functional characterization of the peritoneal mesothelium, a barrier for solute transport. Function (Oxf), 2025, 6(1): zqae051.
7.	Yu F, Chen J, Wang X, et al. Metabolic reprogramming of peritoneal mesothelial cells in peritoneal dialysis-associated fibrosis: therapeutic targets and strategies. Cell Commun Signal, 2025, 23(1): 114.
8.	Levai E, Marinovic I, Bartosova M, et al. Human peritoneal tight junction, transporter and channel expression in health and kidney failure, and associated solute transport. Sci Rep, 2023, 13(1): 17429.
9.	Ito Y, Sun T, Tawada M, et al. Pathophysiological mechanisms of peritoneal fibrosis and peritoneal membrane dysfunction in peritoneal dialysis. Int J Mol Sci, 2024, 25(16): 8607.
10.	Wilson R B. Hypoxia, cytokines and stromal recruitment: parallels between pathophysiology of encapsulating peritoneal sclerosis, endometriosis and peritoneal metastasis. Pleura Peritoneum, 2018, 3(1): 20180103.
11.	Andrews P M, Porter K R. The ultrastructural morphology and possible functional significance of mesothelial microvilli. Anat Rec, 1973, 177(3): 409-426.
12.	Taniguchi T, Mogi K, Tomita H, et al. Sugar-binding profiles of the mesothelial glycocalyx in frozen tissues of mice revealed by lectin staining. Pathol Res Pract, 2024, 262: 155538.
13.	Kang Y, Liu Y, Fu P, et al. Peritoneal fibrosis: from pathophysiological mechanism to medicine. Front Physiol, 2024, 15: 1438952.
14.	Suryantoro S D, Thaha M, Sutanto H, et al. Current insights into cellular determinants of peritoneal fibrosis in peritoneal dialysis: a narrative review. J Clin Med, 2023, 12(13): 4401.
15.	Trionfetti F, Marchant V, González-Mateo G T, et al. Novel aspects of the immune response involved in the peritoneal damage in chronic kidney disease patients under dialysis. Int J Mol Sci, 2023, 24(6): 5763.
16.	Lee Y, Lee J, Park M, et al. Inflammatory chemokine (C-C motif) ligand 8 inhibition ameliorates peritoneal fibrosis. FASEB J, 2023, 37(1): e22632.
17.	Chen Y W, Liao C T, Wu M Y, et al. Pressure induces peritoneal fibrosis and inflammation through CD44 signaling. Ren Fail, 2024, 46(2): 2384586.
18.	Wang Y, Zhang Y, Ma M, et al. Mechanisms underlying the involvement of peritoneal macrophages in the pathogenesis and novel therapeutic strategies for dialysis-induced peritoneal fibrosis. Front Immunol, 2024, 15: 1507265.
19.	Diao X, Zhan C, Ye H, et al. Single-cell transcriptomic reveals the peritoneal microenvironmental change in long-term peritoneal dialysis patients with ultrafiltration failure. iScience, 2024, 27(12): 111383.
20.	Kunoki S, Ikeno M, Tatsukawa H, et al. Transglutaminase 2 in human peritoneal dialysis-related peritoneal injury. Physiol Rep, 2025, 13(18): e70567.
21.	Meng X M, Tang P M K, Li J, et al. TGF-β/Smad signaling in renal fibrosis. Front Physiol, 2015, 6: 82.
22.	Wei Y S, Tsai S Y, Lin S L, et al. Methylglyoxal-stimulated mesothelial cells prompted fibroblast-to-proto-myofibroblast transition. Int J Mol Sci, 2025, 26(2): 813.
23.	Zhao H, Zhang H L, Jia L. High glucose dialysate-induced peritoneal fibrosis: pathophysiology, underlying mechanisms and potential therapeutic strategies. Biomed Pharmacother, 2023, 165: 115246.
24.	Oh S H, Yook J M, Jung H Y, et al. Autophagy caused by oxidative stress promotes TGF-β1-induced epithelial-to-mesenchymal transition in human peritoneal mesothelial cells. Cell Death Dis, 2024, 15(5): 365.
25.	Yung S, Coles G A, Williams J D, et al. The source and possible significance of hyaluronan in the peritoneal cavity. Kidney Int, 1994, 46(2): 527-533.
26.	張怡玲, 安曉紅, 馮永利. 腹膜透析患者透出液透明質酸的變化. 免疫學雜志, 2005, 21(3): S136-S137.
27.	Breborowicz A, Breborowicz M, Oreopoulos D G. Glucose-induced changes in the phenotype of human peritoneal mesothelial cells: effect of L-2-oxothiazolidine carboxylic acid. Am J Nephrol, 2003, 23(6): 471-476.
28.	Yung S, Chen X R, Tsang R C, et al. Reduction of perlecan synthesis and induction of TGF-beta1 in human peritoneal mesothelial cells due to high dialysate glucose concentration: implication in peritoneal dialysis. J Am Soc Nephrol, 2004, 15(5): 1178-1188.
29.	Chan T M, Leung J K, Sun Y, et al. Different effects of amino acid-based and glucose-based dialysate from peritoneal dialysis patients on mesothelial cell ultrastructure and function. Nephrol Dial Transplant, 2003, 18(6): 1086-1094.
30.	Marchant V, Trionfetti F, Tejedor-Santamaria L, et al. BET protein inhibitor JQ1 ameliorates experimental peritoneal damage by inhibition of inflammation and oxidative stress. Antioxidants (Basel), 2023, 12(12): 2055.
31.	Park P W, Pier G B, Preston M J, et al. Syndecan-1 shedding is enhanced by LasA, a secreted virulence factor of Pseudomonas aeruginosa. J Biol Chem, 2000, 275(5): 3057-3064.
32.	Cazacu S M, Zlatian O M, Plesea E L, et al. Predominant Gram-positive etiology may be associated with a lower mortality rate but with higher antibiotic resistance in spontaneous bacterial peritonitis: a 7-year study in a tertiary center in Romania. Life (Basel), 2025, 15(6): 855.
33.	Ishimura T, Ishii A, Yamada H, et al. Matrix metalloproteinase-10 deficiency has protective effects against peritoneal inflammation and fibrosis via transcription factor NFκB pathway inhibition. Kidney Int, 2023, 104(5): 929-942.
34.	Margetts P J. Matrix metalloproteinase 10 and the slow demise of the peritoneal membrane. Kidney Int, 2023, 104(5): 880-882.
35.	Krediet R T, Parikova A. Glucose-induced pseudohypoxia and advanced glycosylation end products explain peritoneal damage in long-term peritoneal dialysis. Perit Dial Int, 2024, 44(1): 6-15.
36.	Fukuda M, Chiwata Y, Narita T, et al. Advanced glycation end products alter the structural integrity, increase the permeability and transform the biocompatibility of collagen within the peritoneal membrane. Hum Cell, 2025, 38(4): 99.
37.	Hashimoto K, Kamijo Y. Current progress in peritoneal dialysis: a narrative review of progress in peritoneal dialysis fluid. Life (Basel), 2025, 15(2): 279.
38.	Kezi? A, Gaji? S, Ostoji? A R, et al. Glycemic control in patients with diabetes on peritoneal dialysis: from glucose sparing approach to glucose monitoring. Life (Basel), 2025, 15(5): 798.
39.	Schaefer B, Bartosova M, Macher-Goeppinger S, et al. Neutral pH and low-glucose degradation product dialysis fluids induce major early alterations of the peritoneal membrane in children on peritoneal dialysis. Kidney Int, 2018, 94(2): 419-429.
40.	Mitsuno R, Nakayama T, Morimoto K, et al. Early initiation of icodextrin reduces peritoneal dialysis-associated peritonitis risk: a retrospective cohort study. Blood Purif, 2025, 54(3): 174-183.
41.	Jagirdar R M, Pitaraki E, Rouka E, et al. Differential effects of biocompatible peritoneal dialysis fluids on human mesothelial and endothelial cells in 2D and 3D phenotypes. Artif Organs, 2024, 48(5): 484-494.
42.	Bonomini M, Masola V, Monaco M P, et al. Coupling osmotic efficacy with biocompatibility in peritoneal dialysis: a stiff challenge. Int J Mol Sci, 2024, 25(6): 3532.
43.	Haider N U, Asad A B, Amjad M. Safety concerns in amino acid-based peritoneal dialysis: acidosis and peritonitis risks. Int Urol Nephrol, 2025. DOI: 10.1007/s11255-025-04831-5.
44.	Bonomini M, Zammit V, Divino-Filho J C, et al. The osmo-metabolic approach: a novel and tantalizing glucose-sparing strategy in peritoneal dialysis. J Nephrol, 2021, 34(2): 503-519.
45.	Kuma A, Tamura M, Ishimatsu N, et al. Monocarboxylate transporter-1 mediates the protective effects of neutral-pH bicarbonate/lactate-buffered peritoneal dialysis fluid on cell viability and apoptosis. Ther Apher Dial, 2017, 21(1): 62-70.
46.	Kratochwill K, Boehm M, Herzog R, et al. Addition of alanyl-glutamine to dialysis fluid restores peritoneal cellular stress responses - a first-in-man trial. PLoS One, 2016, 11(10): e0165045.
47.	Li H, Ma H Y, Hua W L, et al. Trend of research on the medical use of molecular hydrogen: a bibliometric analysis. Med Gas Res, 2023, 13(4): 212-218.
48.	Hirano S I, Ichikawa Y, Sato B, et al. Clinical use and treatment mechanism of molecular hydrogen in the treatment of various kidney diseases including diabetic kidney disease. Biomedicines, 2023, 11(10): 2817.
49.	Riedl Khursigara M, Liu P, Kaur R, et al. Role of SGLT-2 inhibitors in ultrafiltration failure in peritoneal dialysis: a narrative review. Can J Kidney Health Dis, 2024, 11: 20543581241293500.
50.	Roddick A J, Wonnacott A, Webb D, et al. UK Kidney Association Clinical Practice Guideline: sodium-glucose co-transporter-2 (SGLT-2) inhibition in adults with kidney disease 2023 update. BMC Nephrol, 2023, 24(1): 310.
51.	Kamiya K, Hatayama N, Tawada M, et al. Role of endothelial hyaluronan in peritoneal membrane transport and disease conditions during peritoneal dialysis. Sci Rep, 2024, 14(1): 7412.
52.	Kocurkova A, Kerberova M, Nesporova K, et al. Endogenously produced hyaluronan contributes to the regulation of peritoneal adhesion development. Biofactors, 2023, 49(4): 940-955.
53.	Song X, Zha Y, Liu J, et al. Associations between liver function parameters and poor clinical outcomes in peritoneal dialysis patients. Ther Apher Dial, 2023, 27(1): 12-18.
54.	Bazzato G, Fracasso A, Gambaro G, et al. Use of glycosaminoglycans to increase efficiency of long-term continuous peritoneal dialysis. Lancet, 1995, 346(8977): 740-741.
55.	Yung S, Chan T M. Pathophysiology of the peritoneal membrane during peritoneal dialysis: the role of hyaluronan. J Biomed Biotechnol, 2011, 2011: 180594.

1. Seghers F, Tintillier M, Morelle J. Recent advances in the understanding of the peritoneal membrane. Curr Opin Nephrol Hypertens, 2025, 34(1): 77-84.
2. Prasad N, Chaturvedi S, Singh H, et al. Peritoneal dialysis-associated fibrosis: emerging mechanisms and therapeutic opportunities. Front Pharmacol, 2025, 16: 1635624.
3. Parolin M, Ceschia G, Bertazza Partigiani N, et al. Non-infectious complications of peritoneal dialysis in children. Pediatr Nephrol, 2025, 40(10): 3055-3066.
4. Evanko S P, Tammi M I, Tammi R H, et al. Hyaluronan-dependent pericellular matrix. Adv Drug Deliv Rev, 2007, 59(13): 1351-1365.
5. Gaballah A H, Algazzar M, Kazi I A, et al. The peritoneum: anatomy, pathologic findings, and patterns of disease spread. Radiographics, 2024, 44(8): e230216.
6. Marinovic I, Bartosova M, Levai E, et al. Molecular and functional characterization of the peritoneal mesothelium, a barrier for solute transport. Function (Oxf), 2025, 6(1): zqae051.
7. Yu F, Chen J, Wang X, et al. Metabolic reprogramming of peritoneal mesothelial cells in peritoneal dialysis-associated fibrosis: therapeutic targets and strategies. Cell Commun Signal, 2025, 23(1): 114.
8. Levai E, Marinovic I, Bartosova M, et al. Human peritoneal tight junction, transporter and channel expression in health and kidney failure, and associated solute transport. Sci Rep, 2023, 13(1): 17429.
9. Ito Y, Sun T, Tawada M, et al. Pathophysiological mechanisms of peritoneal fibrosis and peritoneal membrane dysfunction in peritoneal dialysis. Int J Mol Sci, 2024, 25(16): 8607.
10. Wilson R B. Hypoxia, cytokines and stromal recruitment: parallels between pathophysiology of encapsulating peritoneal sclerosis, endometriosis and peritoneal metastasis. Pleura Peritoneum, 2018, 3(1): 20180103.
11. Andrews P M, Porter K R. The ultrastructural morphology and possible functional significance of mesothelial microvilli. Anat Rec, 1973, 177(3): 409-426.
12. Taniguchi T, Mogi K, Tomita H, et al. Sugar-binding profiles of the mesothelial glycocalyx in frozen tissues of mice revealed by lectin staining. Pathol Res Pract, 2024, 262: 155538.
13. Kang Y, Liu Y, Fu P, et al. Peritoneal fibrosis: from pathophysiological mechanism to medicine. Front Physiol, 2024, 15: 1438952.
14. Suryantoro S D, Thaha M, Sutanto H, et al. Current insights into cellular determinants of peritoneal fibrosis in peritoneal dialysis: a narrative review. J Clin Med, 2023, 12(13): 4401.
15. Trionfetti F, Marchant V, González-Mateo G T, et al. Novel aspects of the immune response involved in the peritoneal damage in chronic kidney disease patients under dialysis. Int J Mol Sci, 2023, 24(6): 5763.
16. Lee Y, Lee J, Park M, et al. Inflammatory chemokine (C-C motif) ligand 8 inhibition ameliorates peritoneal fibrosis. FASEB J, 2023, 37(1): e22632.
17. Chen Y W, Liao C T, Wu M Y, et al. Pressure induces peritoneal fibrosis and inflammation through CD44 signaling. Ren Fail, 2024, 46(2): 2384586.
18. Wang Y, Zhang Y, Ma M, et al. Mechanisms underlying the involvement of peritoneal macrophages in the pathogenesis and novel therapeutic strategies for dialysis-induced peritoneal fibrosis. Front Immunol, 2024, 15: 1507265.
19. Diao X, Zhan C, Ye H, et al. Single-cell transcriptomic reveals the peritoneal microenvironmental change in long-term peritoneal dialysis patients with ultrafiltration failure. iScience, 2024, 27(12): 111383.
20. Kunoki S, Ikeno M, Tatsukawa H, et al. Transglutaminase 2 in human peritoneal dialysis-related peritoneal injury. Physiol Rep, 2025, 13(18): e70567.
21. Meng X M, Tang P M K, Li J, et al. TGF-β/Smad signaling in renal fibrosis. Front Physiol, 2015, 6: 82.
22. Wei Y S, Tsai S Y, Lin S L, et al. Methylglyoxal-stimulated mesothelial cells prompted fibroblast-to-proto-myofibroblast transition. Int J Mol Sci, 2025, 26(2): 813.
23. Zhao H, Zhang H L, Jia L. High glucose dialysate-induced peritoneal fibrosis: pathophysiology, underlying mechanisms and potential therapeutic strategies. Biomed Pharmacother, 2023, 165: 115246.
24. Oh S H, Yook J M, Jung H Y, et al. Autophagy caused by oxidative stress promotes TGF-β1-induced epithelial-to-mesenchymal transition in human peritoneal mesothelial cells. Cell Death Dis, 2024, 15(5): 365.
25. Yung S, Coles G A, Williams J D, et al. The source and possible significance of hyaluronan in the peritoneal cavity. Kidney Int, 1994, 46(2): 527-533.
26. 張怡玲, 安曉紅, 馮永利. 腹膜透析患者透出液透明質酸的變化. 免疫學雜志, 2005, 21(3): S136-S137.
27. Breborowicz A, Breborowicz M, Oreopoulos D G. Glucose-induced changes in the phenotype of human peritoneal mesothelial cells: effect of L-2-oxothiazolidine carboxylic acid. Am J Nephrol, 2003, 23(6): 471-476.
28. Yung S, Chen X R, Tsang R C, et al. Reduction of perlecan synthesis and induction of TGF-beta1 in human peritoneal mesothelial cells due to high dialysate glucose concentration: implication in peritoneal dialysis. J Am Soc Nephrol, 2004, 15(5): 1178-1188.
29. Chan T M, Leung J K, Sun Y, et al. Different effects of amino acid-based and glucose-based dialysate from peritoneal dialysis patients on mesothelial cell ultrastructure and function. Nephrol Dial Transplant, 2003, 18(6): 1086-1094.
30. Marchant V, Trionfetti F, Tejedor-Santamaria L, et al. BET protein inhibitor JQ1 ameliorates experimental peritoneal damage by inhibition of inflammation and oxidative stress. Antioxidants (Basel), 2023, 12(12): 2055.
31. Park P W, Pier G B, Preston M J, et al. Syndecan-1 shedding is enhanced by LasA, a secreted virulence factor of Pseudomonas aeruginosa. J Biol Chem, 2000, 275(5): 3057-3064.
32. Cazacu S M, Zlatian O M, Plesea E L, et al. Predominant Gram-positive etiology may be associated with a lower mortality rate but with higher antibiotic resistance in spontaneous bacterial peritonitis: a 7-year study in a tertiary center in Romania. Life (Basel), 2025, 15(6): 855.
33. Ishimura T, Ishii A, Yamada H, et al. Matrix metalloproteinase-10 deficiency has protective effects against peritoneal inflammation and fibrosis via transcription factor NFκB pathway inhibition. Kidney Int, 2023, 104(5): 929-942.
34. Margetts P J. Matrix metalloproteinase 10 and the slow demise of the peritoneal membrane. Kidney Int, 2023, 104(5): 880-882.
35. Krediet R T, Parikova A. Glucose-induced pseudohypoxia and advanced glycosylation end products explain peritoneal damage in long-term peritoneal dialysis. Perit Dial Int, 2024, 44(1): 6-15.
36. Fukuda M, Chiwata Y, Narita T, et al. Advanced glycation end products alter the structural integrity, increase the permeability and transform the biocompatibility of collagen within the peritoneal membrane. Hum Cell, 2025, 38(4): 99.
37. Hashimoto K, Kamijo Y. Current progress in peritoneal dialysis: a narrative review of progress in peritoneal dialysis fluid. Life (Basel), 2025, 15(2): 279.
38. Kezi? A, Gaji? S, Ostoji? A R, et al. Glycemic control in patients with diabetes on peritoneal dialysis: from glucose sparing approach to glucose monitoring. Life (Basel), 2025, 15(5): 798.
39. Schaefer B, Bartosova M, Macher-Goeppinger S, et al. Neutral pH and low-glucose degradation product dialysis fluids induce major early alterations of the peritoneal membrane in children on peritoneal dialysis. Kidney Int, 2018, 94(2): 419-429.
40. Mitsuno R, Nakayama T, Morimoto K, et al. Early initiation of icodextrin reduces peritoneal dialysis-associated peritonitis risk: a retrospective cohort study. Blood Purif, 2025, 54(3): 174-183.
41. Jagirdar R M, Pitaraki E, Rouka E, et al. Differential effects of biocompatible peritoneal dialysis fluids on human mesothelial and endothelial cells in 2D and 3D phenotypes. Artif Organs, 2024, 48(5): 484-494.
42. Bonomini M, Masola V, Monaco M P, et al. Coupling osmotic efficacy with biocompatibility in peritoneal dialysis: a stiff challenge. Int J Mol Sci, 2024, 25(6): 3532.
43. Haider N U, Asad A B, Amjad M. Safety concerns in amino acid-based peritoneal dialysis: acidosis and peritonitis risks. Int Urol Nephrol, 2025. DOI: 10.1007/s11255-025-04831-5.
44. Bonomini M, Zammit V, Divino-Filho J C, et al. The osmo-metabolic approach: a novel and tantalizing glucose-sparing strategy in peritoneal dialysis. J Nephrol, 2021, 34(2): 503-519.
45. Kuma A, Tamura M, Ishimatsu N, et al. Monocarboxylate transporter-1 mediates the protective effects of neutral-pH bicarbonate/lactate-buffered peritoneal dialysis fluid on cell viability and apoptosis. Ther Apher Dial, 2017, 21(1): 62-70.
46. Kratochwill K, Boehm M, Herzog R, et al. Addition of alanyl-glutamine to dialysis fluid restores peritoneal cellular stress responses - a first-in-man trial. PLoS One, 2016, 11(10): e0165045.
47. Li H, Ma H Y, Hua W L, et al. Trend of research on the medical use of molecular hydrogen: a bibliometric analysis. Med Gas Res, 2023, 13(4): 212-218.
48. Hirano S I, Ichikawa Y, Sato B, et al. Clinical use and treatment mechanism of molecular hydrogen in the treatment of various kidney diseases including diabetic kidney disease. Biomedicines, 2023, 11(10): 2817.
49. Riedl Khursigara M, Liu P, Kaur R, et al. Role of SGLT-2 inhibitors in ultrafiltration failure in peritoneal dialysis: a narrative review. Can J Kidney Health Dis, 2024, 11: 20543581241293500.
50. Roddick A J, Wonnacott A, Webb D, et al. UK Kidney Association Clinical Practice Guideline: sodium-glucose co-transporter-2 (SGLT-2) inhibition in adults with kidney disease 2023 update. BMC Nephrol, 2023, 24(1): 310.
51. Kamiya K, Hatayama N, Tawada M, et al. Role of endothelial hyaluronan in peritoneal membrane transport and disease conditions during peritoneal dialysis. Sci Rep, 2024, 14(1): 7412.
52. Kocurkova A, Kerberova M, Nesporova K, et al. Endogenously produced hyaluronan contributes to the regulation of peritoneal adhesion development. Biofactors, 2023, 49(4): 940-955.
53. Song X, Zha Y, Liu J, et al. Associations between liver function parameters and poor clinical outcomes in peritoneal dialysis patients. Ther Apher Dial, 2023, 27(1): 12-18.
54. Bazzato G, Fracasso A, Gambaro G, et al. Use of glycosaminoglycans to increase efficiency of long-term continuous peritoneal dialysis. Lancet, 1995, 346(8977): 740-741.
55. Yung S, Chan T M. Pathophysiology of the peritoneal membrane during peritoneal dialysis: the role of hyaluronan. J Biomed Biotechnol, 2011, 2011: 180594.

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