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No. 95 (PO 9)
Number and morphology of mesothelial cells in peritoneal dialysis effluent as a
potential predictive marker for advanced peritoneal dysfunction
Mayumi Idei 1 , Yoko Tabe 1 , Kazunori Miyake 1 , Chieko Hamada 2 , Hiroyuki Takemura 3 , Hiroaki
Io 2 , Kiyoshi Ishii 3 , Takashi Horii 3 , Yasuhiko Tomino 2 , Akimichi Ohsaka 3 , Takashi Miida 1
1, Department of Clinical Laboratory Medicine, Juntendo University School of Medicine, Tokyo, Japan
2, Division of Nephrology, Department of Internal Medicine, Juntendo University School of Medicine ,
Tokyo, Japan
3, Division of Clinical Laboratory, Juntendo University Hospital, Tokyo, Japan
Encapsulating peritoneal sclerosis (EPS) is a serious complication of peritoneal dialysis (PD). A risk
of EPS increases with a development of peritoneal dysfunction where increased peritoneal permeability
is associated with exfoliation and loss of peritoneal mesothelial cells.
In this study, we investigated whether the number and morphology of mesothelial cells in peritoneal
dialysis effluent (PDE) reflect a peritoneal function, and predict increased susceptibility to EPS.
Materials and Methods: PDE samples were obtained from 33 PD patients (26 men, 7 women, PD
duration; 29.1 ± 27.4 months) with peritoneal equilibration test (PET) performed. The number of
mesothelial cells was counted in 36 mm 2 area of slide preparation. According to the classification of cell
morphology based on the life-cycle of mesothelial cells, mesothelial cells were classified into quiescent,
activated, phagocytic, and degenerating cells with the digital microscopy system CellaVision DM96.
PET was used to categorize patients into four transporter groups; high (H), high average (HA), low
average (LA), and low (L).
Results: The number of mesothelial cells in PDE samples was significantly lower in H transporter
group than HA (p < 0.05). Mean numbers of mesothelial cells were 2.7 ± 0.6 for H transporter group
(n=3), 15.8 ± 11.4 for HA (n = 16), and 14.8 ± 21.7 for LA (n = 11), and 11.3 ± 12.9 for L (n=3),
respectively. In morphological analysis, whereas both quiescent- and activated- mesothelial cells were
present in HA, LA, and L transporter groups, in H transporter group, however, quiescent cell type was
predominantly observed.
Conclusions: Decreased number of mesothelial cells in PDE of a high transporter membrane state,
suggesting the loss of peritoneal mesothelial cells during chronic peritoneal injury, might be a
convenient and useful predictive marker for advanced peritoneal dysfunction.
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