{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T22:40:33Z","timestamp":1783118433824,"version":"3.54.6"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["iNOVA4Health"],"award-info":[{"award-number":["iNOVA4Health"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007044","name":"Sociedade Portuguesa de Nefrologia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007044","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Long\u2010term success of peritoneal dialysis relies on the integrity of the peritoneal membrane. This proof\u2010of\u2010concept study addressed the hypothesis that fibrosis is already present in the membrane at pre\u2010dialysis and that the membrane status is related to the individual's uraemic fingerprint.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A clinical\u2010mechanistic, transversal, single\u2010centre study was conducted. Pre\u2010dialysis 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 (\u03b1\u2010Klotho, Galectin\u20103, FGF21, FGF23, Tweak, TNF\u03b1 and hsPCR) in blood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total 58 incident patients aged 56\u2009\u00b1\u200915\u2009years old were included, 31% female, 55% hypertension, 29% diabetic and 24% obese. Person\u2010to\u2010person STM was found to be highly variable and 38% of patients were fibrosis positive. Both \u03b1\u2010Klotho (<jats:italic>Spearman r<\/jats:italic>\u00a0=\u2009\u2212.7491, <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001) and FGF21 (<jats:italic>Spearman r<\/jats:italic>\u00a0=\u2009\u2212.5102, <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001) were negatively associated with STM. \u03b1\u2010Klotho, but not FGF21, was able to discriminate fibrosis from nonfibrosis with\/without inflammation and vasculopathy. PLS models identified \u03b1\u2010Klotho as the protein most relevant for fibrosis. \u03b1\u2010Klotho was independently associated with fibrosis of the peritoneal membrane (OR\u00a0=\u00a0.991 (.896\u2013.997), <jats:italic>p<\/jats:italic>\u00a0=\u20090.002).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Before the start of dialysis in incident patients, some patients already present fibrosis of the peritoneal membrane and other patients do not. Our findings suggest that \u03b1\u2010Klotho may be implicated in fibrosis of the peritoneal membrane.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.13903","type":"journal-article","created":{"date-parts":[[2022,11,15]],"date-time":"2022-11-15T06:41:18Z","timestamp":1668494478000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Alpha\u2010klotho and peritoneal membrane status: A\u00a0hypothesis generating study"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8563-834X","authenticated-orcid":false,"given":"Patr\u00edcia","family":"Branco","sequence":"first","affiliation":[{"name":"Nephrology Department Hospital Santa Cruz, Centro Hospitalar de Lisboa Ocidental (CLHO)  Lisboa Portugal"},{"name":"iNOVA4Health, NOVA Medical School|Faculdade de Ci\u00eancias M\u00e9dicas NMS|FCM, Universidade Nova de Lisboa  Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Rita","family":"Martins","sequence":"additional","affiliation":[{"name":"Nephrology Department Hospital Santa Cruz, Centro Hospitalar de Lisboa Ocidental (CLHO)  Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Cal\u00e7a","sequence":"additional","affiliation":[{"name":"Nephrology Department Hospital Santa Cruz, Centro Hospitalar de Lisboa Ocidental (CLHO)  Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catarina","family":"Mateus","sequence":"additional","affiliation":[{"name":"Nephrology Department Hospital Santa Cruz, Centro Hospitalar de Lisboa Ocidental (CLHO)  Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria\u00a0Jo\u00e3o","family":"Jervis","sequence":"additional","affiliation":[{"name":"Surgery Department Hospital Santa Cruz, Centro Hospitalar de Lisboa Ocidental (CLHO)  Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anabela","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"UMIB\u2013Unidade Multidisciplinar de Investiga\u00e7\u00e3o Biom\u00e9dica, ICBAS\u2013Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar, Universidade do Porto, ITR\u2013Laboratory for Integrative and Translational Research in Population Health  Porto Portugal"},{"name":"Departamento de Nefrologia Centro Hospitalar Universit\u00e1rio do Porto (CHUPorto)  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia Azeredo","family":"Lopes","sequence":"additional","affiliation":[{"name":"CHRC, NOVA Medical School|Faculdade de Ci\u00eancias M\u00e9dicas, NMS|FCM Universidade Nova de Lisboa  Lisboa Portugal"},{"name":"Department of Statistics and Operational Research, Faculdade de Ci\u00eancias Universidade de Lisboa  Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ester","family":"Civantos","sequence":"additional","affiliation":[{"name":"Renal, Vascular and Diabetes Research Laboratory, IIS\u2010Fundaci\u00f3n Jim\u00e9nez D\u00edaz Universidad Aut\u00f3noma de Madrid Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Mas\u2010Fontao","sequence":"additional","affiliation":[{"name":"Renal, Vascular and Diabetes Research Laboratory, IIS\u2010Fundaci\u00f3n Jim\u00e9nez D\u00edaz Universidad Aut\u00f3noma de Madrid Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augusta","family":"Gaspar","sequence":"additional","affiliation":[{"name":"Nephrology Department Hospital Santa Cruz, Centro Hospitalar de Lisboa Ocidental (CLHO)  Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e2ncia","family":"Ramos","sequence":"additional","affiliation":[{"name":"Pathology Department Hospital Santa Cruz, Centro Hospitalar de Lisboa Ocidental (CLHO)  Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judit","family":"Morello","sequence":"additional","affiliation":[{"name":"iNOVA4Health, NOVA Medical School|Faculdade de Ci\u00eancias M\u00e9dicas NMS|FCM, Universidade Nova de Lisboa  Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel\u00a0Pinto","family":"Gomes","sequence":"additional","affiliation":[{"name":"Pathology Department Hospital Santa Cruz, Centro Hospitalar de Lisboa Ocidental (CLHO)  Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8456-9995","authenticated-orcid":false,"given":"Sofia Azeredo","family":"Pereira","sequence":"additional","affiliation":[{"name":"iNOVA4Health, NOVA Medical School|Faculdade de Ci\u00eancias M\u00e9dicas NMS|FCM, Universidade Nova de Lisboa  Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfr674"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/1744-9987.12756"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2020.05.032"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/membranes12030318"},{"issue":"2","key":"e_1_2_7_6_1","first-page":"12","article-title":"Is peritoneal dialysis an effective treatment for cardiorenal syndrome with decompensated heart failure? A single center experience","volume":"7","author":"Silva F","year":"2022","journal-title":"Med Clin Res"},{"issue":"3","key":"e_1_2_7_7_1","first-page":"132","article-title":"Quality of life in patients undergoing hemodialysis or peritoneal dialysis treatment","volume":"3","author":"Theofilou P","year":"2011","journal-title":"J Clin Med Res"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2016.181"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/toxins12040227"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-012-0271-4"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/590851"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.V132470"},{"key":"e_1_2_7_13_1","first-page":"3","article-title":"Categorization of ultrastructural changes in peritoneal mesothelium, stroma and blood vessels in uremia and CAPD patients","volume":"6","author":"Dobbie JW","year":"1990","journal-title":"Adv Perit Dial"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.03630807"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2009070694"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/089686080202200309"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/089686080402400416"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2017080828"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cellsig.2020.109778"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2012.05.018"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.3747\/pdi.2011.00205"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2016.03.040"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI64184"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/toxins9040114"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/apha.13190"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2013.05.046"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2010101073"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/MNH.0000000000000231"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.2011.02476.x"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2021.154738"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfz298"}],"container-title":["European Journal of Clinical Investigation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/eci.13903","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/eci.13903","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/eci.13903","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T21:13:16Z","timestamp":1692393196000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/eci.13903"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12]]},"references-count":30,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1111\/eci.13903"],"URL":"https:\/\/doi.org\/10.1111\/eci.13903","archive":["Portico"],"relation":{},"ISSN":["0014-2972","1365-2362"],"issn-type":[{"value":"0014-2972","type":"print"},{"value":"1365-2362","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12]]},"assertion":[{"value":"2022-08-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-17","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13903"}}