{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T12:49:39Z","timestamp":1768999779774,"version":"3.49.0"},"reference-count":55,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,3,6]],"date-time":"2023-03-06T00:00:00Z","timestamp":1678060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Sociedade Portuguesa de Nefrologia (SPN)","award":["UIDP\/04462\/2020"],"award-info":[{"award-number":["UIDP\/04462\/2020"]}]},{"name":"Jim\u00e9nez D\u00edaz Foundation University Hospital, Madrid","award":["UIDP\/04462\/2020"],"award-info":[{"award-number":["UIDP\/04462\/2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Peritoneal membrane status, clinical data and aging-related molecules were investigated as predictors of long-term peritoneal dialysis (PD) outcomes. A 5-year prospective study was conducted with the following endpoints: (a) PD failure and time until PD failure, (b) major cardiovascular event (MACE) and time until MACE. A total of 58 incident patients with peritoneal biopsy at study baseline were included. Peritoneal membrane histomorphology and aging-related indicators were assessed before the start of PD and investigated as predictors of study endpoints. Fibrosis of the peritoneal membrane was associated with MACE occurrence and earlier MACE, but not with the patient or membrane survival. Serum \u03b1-Klotho bellow 742 pg\/mL was related to the submesothelial thickness of the peritoneal membrane. This cutoff stratified the patients according to the risk of MACE and time until MACE. Uremic levels of galectin-3 were associated with PD failure and time until PD failure. This work unveils peritoneal membrane fibrosis as a window to the vulnerability of the cardiovascular system, whose mechanisms and links to biological aging need to be better investigated. Galectin-3 and \u03b1-Klotho are putative tools to tailor patient management in this home-based renal replacement therapy.<\/jats:p>","DOI":"10.3390\/ijms24055020","type":"journal-article","created":{"date-parts":[[2023,3,6]],"date-time":"2023-03-06T04:29:58Z","timestamp":1678076998000},"page":"5020","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Fibrosis of Peritoneal Membrane, Molecular Indicators of Aging and Frailty Unveil Vulnerable Patients in Long-Term Peritoneal Dialysis"],"prefix":"10.3390","volume":"24","author":[{"given":"Patr\u00edcia","family":"Branco","sequence":"first","affiliation":[{"name":"Nephrology Department, Hospital Santa Cruz, Centro Hospitalar de Lisboa Ocidental (CHLO), 2790-134 Lisboa, Portugal"},{"name":"iNOVA4Health, NOVA Medical School|Faculdade de Ci\u00eancias M\u00e9dicas, NMS|FCM, Universidade Nova de Lisboa, 1150-082 Lisboa, Portugal"},{"name":"Centro Cl\u00ednico Acad\u00e9mico de Lisboa, 1159-056 Lisboa, Portugal"}]},{"given":"Rita","family":"Cal\u00e7a","sequence":"additional","affiliation":[{"name":"Nephrology Department, Hospital Santa Cruz, Centro Hospitalar de Lisboa Ocidental (CHLO), 2790-134 Lisboa, Portugal"},{"name":"iNOVA4Health, NOVA Medical School|Faculdade de Ci\u00eancias M\u00e9dicas, NMS|FCM, Universidade Nova de Lisboa, 1150-082 Lisboa, Portugal"},{"name":"Centro Cl\u00ednico Acad\u00e9mico de Lisboa, 1159-056 Lisboa, Portugal"}]},{"given":"Ana","family":"Martins","sequence":"additional","affiliation":[{"name":"Nephrology Department, Hospital Santa Cruz, Centro Hospitalar de Lisboa Ocidental (CHLO), 2790-134 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3558-6286","authenticated-orcid":false,"given":"Catarina","family":"Mateus","sequence":"additional","affiliation":[{"name":"Nephrology Department, Hospital Santa Cruz, Centro Hospitalar de Lisboa Ocidental (CHLO), 2790-134 Lisboa, Portugal"}]},{"given":"Maria","family":"Jervis","sequence":"additional","affiliation":[{"name":"Surgery Department, Hospital Santa Cruz, Centro Hospitalar de Lisboa Ocidental (CHLO), 2740-134 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8318-0945","authenticated-orcid":false,"given":"Daniel","family":"Gomes Pinto","sequence":"additional","affiliation":[{"name":"Pathology Department, Hospital Santa Cruz, Centro Hospitalar de Lisboa Ocidental (CHLO), 2740-134 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4655-4987","authenticated-orcid":false,"given":"Sofia","family":"Azeredo-Lopes","sequence":"additional","affiliation":[{"name":"CHRC, NMS|FCM, Universidade Nova de Lisboa, 1150-082 Lisboa, Portugal"},{"name":"Department of Statistics and Operational Research, Faculdade de Ci\u00eancias, Universidade de Lisboa, 1749-016 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6831-1823","authenticated-orcid":false,"given":"Antonio","family":"De Melo Junior","sequence":"additional","affiliation":[{"name":"iNOVA4Health, NOVA Medical School|Faculdade de Ci\u00eancias M\u00e9dicas, NMS|FCM, Universidade Nova de Lisboa, 1150-082 Lisboa, Portugal"},{"name":"Centro Cl\u00ednico Acad\u00e9mico de Lisboa, 1159-056 Lisboa, Portugal"}]},{"given":"C\u00e1tia","family":"Sousa","sequence":"additional","affiliation":[{"name":"iNOVA4Health, NOVA Medical School|Faculdade de Ci\u00eancias M\u00e9dicas, NMS|FCM, Universidade Nova de Lisboa, 1150-082 Lisboa, Portugal"},{"name":"Centro Cl\u00ednico Acad\u00e9mico de Lisboa, 1159-056 Lisboa, Portugal"}]},{"given":"Ester","family":"Civantos","sequence":"additional","affiliation":[{"name":"Renal, Vascular and Diabetes Research Laboratory, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, Universidad Aut\u00f3noma de Madrid, Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), 28029 Madrid, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6604-3327","authenticated-orcid":false,"given":"Sebastian","family":"Mas-Fontao","sequence":"additional","affiliation":[{"name":"Renal, Vascular and Diabetes Research Laboratory, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, Universidad Aut\u00f3noma de Madrid, Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), 28029 Madrid, Spain"}]},{"given":"Augusta","family":"Gaspar","sequence":"additional","affiliation":[{"name":"Nephrology Department, Hospital Santa Cruz, Centro Hospitalar de Lisboa Ocidental (CHLO), 2790-134 Lisboa, Portugal"}]},{"given":"S\u00e2ncia","family":"Ramos","sequence":"additional","affiliation":[{"name":"Pathology Department, Hospital Santa Cruz, Centro Hospitalar de Lisboa Ocidental (CHLO), 2740-134 Lisboa, Portugal"}]},{"given":"Judit","family":"Morello","sequence":"additional","affiliation":[{"name":"iNOVA4Health, NOVA Medical School|Faculdade de Ci\u00eancias M\u00e9dicas, 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