The Relationship Of Vascular Endothelial Growth Factor And Mechanism Of The Ultrafiltration Failure Of Peritoneal Dialysis

Objective: To investigate the epidemic data of the ultrafiltration failure of peritoneal dialysis to clarify the cause of it. Futher ,to study the role of vascular endothelial growth factor (VEGF) on the ultrafiltration failure of peritoneal dialysis in vitro and in vivo.Methods: 1.Respective analysis method was applied to collect the epidemic data of the peritoneal dialysis patients to analysis the relationship of the duration of peritoneal dialysis, peritonitis, serum albumin ,high glucose accumulation and peritoneal small molecular weight solute transport rate with the ultrafiltration failure of peritoneal dialysis ; immunohistochemistry was applied to detect the peritoneal neoangiogenesis(VIII factor) and the expression of peritoneal VEGF; 2. Reverse transcription polymerase chain reaction (RT-PCR) was applied to study the mRNA expression of VEGF, HIF1, AQP1 of HPMC under high glucose concentrations or uremic serum conditions , immunohistochemistry was applied to detect the effects of expression of the protein of VEGF, AQP1 of HPMC under the same conditions . Results: l.The prevalence rate of peritoneal ultrafiltration failure is 17.2% and peritoneal high transport status of small molecular weight solute is positively associated with the duration of peritoneal dialysis or high glucose accumulation; 2.The increased expression of peritoneal neoangiogensis and VEGF is found in the patients of peritoneal ultrafiltration failure; 3.High glucose concentration or uremic serum can upregulate the expression of VEGF, HIF1, AQP1 in HPMC, and the latters are positively associated with VEGF.Conclusions: 1. The long term effects of high glucose concentration dialysate may induce increased peritoneal neoangiogensis and enhance expression of VEGF to lead to the peritoneal ultrafiltration failure, High glucose concentration dialysate may be the cause of the peritoneal ultrafiltration failure. 2.High glucose or uremic serum upregulates the expression of VEGF and it may induce the increasement of neoangiogensis. Further, it may cause the incidence of peritoneal ultrafiltration faiure. 3. The regulation of VEGF in HPMC under high glucose concentration or uremic serum conditions may be through HIF1 pathway. 4.That the expression of AQP1 and VEGF are positively associated suggested dysfunction of AQP1 may beone of the mechanisms of peritoneal ultraflltration failure.