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CTGF production with and without TGF-\u03b2<jats:sub>1<\/jats:sub>stimulation in human peritoneal mesothelial cells (HPMC) from the spent patients' peritoneal dialysate ( n = 32) was studied in vitro. The dialysate-to-plasma ratio for creatinine (D\/P Cr) was positively correlated to dialysate CTGF concentration and estimated local peritoneal production of CTGF. CTGF mRNA expression was 11.4-fold higher in peritoneal membranes with UFF than in pre-PD renal failure peritoneum and was correlated with thickness of the peritoneum. CTGF protein and mRNA were detected in mesothelium and in fibroblast-like cells. In cultured HPMC, TGF-\u03b2<jats:sub>1<\/jats:sub>-induced expression of CTGF mRNA was increased at 12 and 24 h and was correlated with D\/P Cr. In contrast, bone morphogenic protein-4 mRNA expression was inversely correlated with D\/P Cr. Our results suggest that high peritoneal transport state is associated with fibrosis and increased peritoneal CTGF expression and production by mesothelial cells, which can be stimulated by TGF-\u03b2<jats:sub>1<\/jats:sub>. Dialysate CTGF concentration could be a biomarker for both peritoneal fibrosis and membrane function. 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