Soluble CD59 in peritoneal dialysis: a potential biomarker for peritoneal membrane function
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ORIGINAL ARTICLE
Soluble CD59 in peritoneal dialysis: a potential biomarker for peritoneal membrane function Bernardo Faria1,2 · Mariana Gaya da Costa1 · Carla Lima3 · Loek Willems4 · Ricardo Brandwijk4 · Stefan P. Berger1 · Mohamed R. Daha1,5 · Manuel Pestana2 · Marc A. Seelen1 · Felix Poppelaars1 Received: 21 August 2020 / Accepted: 19 November 2020 © The Author(s) 2020
Abstract Introduction Various studies have reported the importance of complement regulators in preventing mesothelial damage during peritoneal dialysis (PD). Its assessment, however, is limited in clinical practice due to the lack of easy access to the peritoneal membrane. Recently, a soluble form of the complement regulatory protein CD59 (sCD59) has been described. We therefore aimed to investigate the role of sCD59 in PD. Methods Plasma sCD59 was measured in 48 PD patients, 41 hemodialysis patients, 15 non-dialysis patients with chronic kidney disease and 14 healthy controls by ELISA (Hycult; HK374-02). Additionally, sCD59 and sC5b-9 were assessed in the peritoneal dialysate. Results sCD59 and sC5b-9 were detectable in the peritoneal dialysate of all patients, and marginally correlated (r = 0.27, P = 0.06). Plasma sCD59 levels were significantly higher in PD patients than in patients with chronic kidney disease and healthy controls, but did not differ from hemodialysis patients. During follow-up, 19% of PD patients developed peritoneal membrane failure and 27% of PD patients developed loss of residual renal function. In adjusted models, increased sCD59 levels in the dialysate (HR 3.44, 95% CI 1.04–11.40, P = 0.04) and in plasma (HR 1.08, 95% CI 1.01–1.17, P = 0.04) were independently associated with the occurrence of peritoneal membrane failure. Higher plasma levels of sCD59 were also associated with loss of residual renal function (HR 1.10, 95% CI 1.04–1.17, P
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