Matrix metalloproteinase-2 as a superior biomarker for peritoneal deterioration in peritoneal dialysis

AIM: To investigate the efficacy of effluent biomarkers for peritoneal deterioration with functional decline in peritoneal dialysis(PD). METHODS: From January 2005 to March 2013, the subjects included 218 PD patients with end-stage renal disease at 18 centers. Matrix metalloproteinase-2(MMP-2), interleukin-6(IL-6), hyaluronan, and cancer antigen 125(CA125) in peritoneal effluent were quantified with enzyme-linked immunosorbent assay. Peritoneal solute transport rate was assessed by peritoneal equilibration test(PET) to estimate peritoneal deterioration. RESULTS: The ratio of the effluent level of creatinine(Cr) obtained 4 h after injection(D) to that of plasma was correlated with the effluent levels of MMP-2(ρ = 0.74, P < 0.001), IL-6(ρ = 0.46, P < 0.001), and hyaluronan(ρ = 0.27, P < 0.001), but not CA125(ρ = 0.13, P = 0.051). The area under receiver operating characteristic curve for the effluent levels of MMP-2, IL-6, and hyaluronan against high PET category were 0.90, 0.78, 0.62, and 0.51, respectively. No patient developed new-onset encapsulating peritoneal sclerosis for at least 1.5 years after peritoneal effluent sampling.CONCLUSION: The effluent MMP-2 level most closely reflected peritoneal solute transport rate. MMP-2 can be a reliable indicator of peritoneal deterioration with functional decline.