Morphological changes of the peritoneal membrane in patients with long-term dialysis

Vol. 55 No. 3 Suppl., 2014
This supplement was not sponsored by Outside Organizations.


Traian Taranu, Laura Florea, Dumitru Paduraru, Stefan Octavian Georgescu, Laurian Lucian Francu, Cristinel Ionel Stan

Morphological alterations of peritoneum in chronically dialyzed patients involve fibrosis and angiogenesis as pathogenic mechanisms. The aim of this retrospective study was to evaluate morphological changes of peritoneum in chronic peritoneal dialysis (PD) at 4, 8, 12, and 14 years. Peritoneal changes were investigated in 110 patients with end stage renal failure, which were included in a PD program. Intraoperative biopsies were grouped in four study Groups (A: 1-48 months, B: 49-96 months, C: 97-144 months, and D: 145-168 months), and were processed histologically and stereologically. Mesothelial denudation was found in percentage volumes of 5.49% - Group A, 16.10% - Group B, 16.68% - Group C and 19.88% - Group D. Reduplication of the basement membrane was observed in patients with over five years of PD. Interstitial stromal fibrosis recorded percentage volumes of 25.49% (Group A), 26.10% (Group B), 35.85% (Group C) and 56.63% for the patient with 14 years of PD. Subendothelial hyalinizing vasculopathy was recorded in percentage volumes of 2.22%, 6.63%, 9.16% up to 9.20%. Vascular permeability reduction was recorded as decreasing percentage volumes from 22.59% to 12.81%, 7.77% and 7.37%. Perivascular inflammation was marked in the serosa of the patients in Group A (4.55%). Calcifications recorded percentage volumes of 1.63% at eight years, 3.74% at 12 years and 4.03% at 14 years of PD. Peritoneal morphological changes appear at 3-4 years of PD and progressively aggravate with long-term PD.

Corresponding author: Laura Florea, MD; e-mail:

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Gratian Dragoslav Miclaus, Ioan Sas, Shamfa C. Joseph, Petru Matusz, Horia Ples, R. Shane Tubbs, Marios Loukas

We report an atypical case of a 63-year-old male with the presence of seven renal arteries (RAs) (three right and four left) found incidentally on multi-detector computed tomography (MDCT) angiography which was used to investigate peripheral vascular disease of the lower limbs. Each arterial lumen was analyzed for the diameter at its origin; length and trajectory in the frontal plane (ascendant + or descendant -); and the distance between the point of origin from the abdominal aorta (AA) to its renal intraparenchymal penetration point. We also analyzed the distance between the extreme points of origin of the right and left RAs from the AA and the distance between the extreme points of penetration into the renal parenchyma of the right and left RAs. On each side, the endoluminal diameter at the origin of the main RA was significantly larger than that of the other AdRAs; however, the AdRAs were much longer than that of the main RA. From the six AdRAs, four were hilar RAs and two were superior polar RAs. Knowledge of such cases is of great clinical significance, as it may be beneficial in various urological operations or invasive arterial procedures._x000D_

Corresponding author: Horia Ples, Senior Lecturer, MD, PhD; e-mail:

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