Alpha‐klotho and peritoneal membrane status: A hypothesis generating study

Background Long‐term success of peritoneal dialysis relies on the integrity of the peritoneal membrane. This proof‐of‐concept study addressed the hypothesis that fibrosis is already present in the membrane at pre‐dialysis and that the membrane status is related to the individual's uraemic fingerprint. Methods A clinical‐mechanistic, transversal, single‐centre study was conducted. Pre‐dialysis peritoneal biopsies were scored considering the submesothelial compact zone thickness (STM), vasculopathy and inflammation. We investigated if the membrane status could be inferred from a panel of proteins (α‐Klotho, Galectin‐3, FGF21, FGF23, Tweak, TNFα and hsPCR) in blood. Results A total 58 incident patients aged 56 ± 15 years old were included, 31% female, 55% hypertension, 29% diabetic and 24% obese. Person‐to‐person STM was found to be highly variable and 38% of patients were fibrosis positive. Both α‐Klotho (Spearman r = −.7491, p