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The aim of our study was to better understand the underlying mechanisms. The effects of additional NaCl were investigated on human primary mesothelial cells (HPMC), human primary peritoneal fibroblasts (HPF), endothelial cells (HUVEC), immune cells (PBMC), as well as ex vivo on peritoneal tissue samples. Our results showed that a high-salt environment and the consequently increased osmolarity increase the production of inflammatory cytokines, profibrotic growth factors, and components of the renin\u2013angiotensin\u2013aldosterone system, including IL1B, IL6, MCP1, TGFB1, PDGFB, CTGF, Renin and Ace both in vitro and ex vivo. We also demonstrated that high salt induces mesenchymal transition by decreasing the expression of epithelial marker CDH1 and increasing the expression of mesenchymal marker ACTA2 and SNAIL1 in HPMCs, HUVECs and peritoneal samples. Furthermore, high salt increased extracellular matrix production in HPFs. We demonstrated that excess Na+ and the consequently increased osmolarity induce a comprehensive profibrotic response in the peritoneal cells, thereby facilitating the development of peritoneal fibrosis.<\/jats:p>","DOI":"10.3390\/ijms241813765","type":"journal-article","created":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T10:07:37Z","timestamp":1693994857000},"page":"13765","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["High Salt Promotes Inflammatory and Fibrotic Response in Peritoneal Cells"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1718-1210","authenticated-orcid":false,"given":"Domonkos","family":"Pap","sequence":"first","affiliation":[{"name":"Pediatric Center, MTA Center of Excellence, Semmelweis University, 1085 Budapest, Hungary"},{"name":"HUN-REN\u2013SU Pediatrics and Nephrology Research Group, 1052 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Csenge","family":"Pajt\u00f3k","sequence":"additional","affiliation":[{"name":"Pediatric Center, MTA Center of Excellence, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6830-8779","authenticated-orcid":false,"given":"Apor","family":"Veres-Sz\u00e9kely","sequence":"additional","affiliation":[{"name":"Pediatric Center, MTA Center of Excellence, Semmelweis University, 1085 Budapest, Hungary"},{"name":"HUN-REN\u2013SU Pediatrics and Nephrology Research Group, 1052 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Be\u00e1ta","family":"Szebeni","sequence":"additional","affiliation":[{"name":"Pediatric Center, MTA Center of Excellence, Semmelweis University, 1085 Budapest, Hungary"},{"name":"HUN-REN\u2013SU Pediatrics and Nephrology Research Group, 1052 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Csenge","family":"Sz\u00e1sz","sequence":"additional","affiliation":[{"name":"Pediatric Center, MTA Center of Excellence, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e9ter","family":"Bokrossy","sequence":"additional","affiliation":[{"name":"Pediatric Center, MTA Center of Excellence, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00e9ka","family":"Zrufk\u00f3","sequence":"additional","affiliation":[{"name":"Pediatric Center, MTA Center of Excellence, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1d\u00e1m","family":"Vannay","sequence":"additional","affiliation":[{"name":"Pediatric Center, MTA Center of Excellence, Semmelweis University, 1085 Budapest, Hungary"},{"name":"HUN-REN\u2013SU Pediatrics and Nephrology Research Group, 1052 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tivadar","family":"Tulassay","sequence":"additional","affiliation":[{"name":"Pediatric Center, MTA Center of Excellence, Semmelweis University, 1085 Budapest, Hungary"},{"name":"HUN-REN\u2013SU Pediatrics and Nephrology Research Group, 1052 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Attila J.","family":"Szab\u00f3","sequence":"additional","affiliation":[{"name":"Pediatric Center, MTA Center of Excellence, Semmelweis University, 1085 Budapest, Hungary"},{"name":"HUN-REN\u2013SU Pediatrics and Nephrology Research Group, 1052 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1159\/000514550","article-title":"Global Epidemiology of End-Stage Kidney Disease and Disparities in Kidney Replacement Therapy","volume":"52","author":"Thurlow","year":"2021","journal-title":"Am. 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