Hence, high glucose condition in PD dialysate may stimulate AM expression and AM may play a role in the peritoneal PU-H71 status and serve as an indicator of PD patients. The peritoneum is composed not only of PMCs but also endothelial cells, fibroblasts and adipocytes. However, AM expression has not been confirmed in PMCs, which are a major constituent of the peritoneum. In this study of PD patients, AM and mAM levels were compared

with the level of CA125, a bulk marker for the mesothelial mass [8], as well as evaluating amidation activity. Methods Patients Twenty patients (male:female 12:8) treated with PD were enrolled in this study after obtaining informed consent (Table 1). The protocol was approved by the Ethics Review Board of Saitama Medical Center, Saitama Medical University. Heart failure (volume overload) was excluded. Patients were maintained on PD with exchange volumes of 1,500 or 2,000 mL and with at least four exchanges per day. Glucose concentrations of dialysate ranged from

1,350 to 2,272 mg/dL (average 1,611 mg/dL). Icodextrin-based dialysate and pH-neutral peritoneal dialysate were not used. In the present study we used the peritoneal equilibration test (PET) which was devised by Twardowski [9] as a grasp method for examination of peritoneal permeability. Standardized PET was performed on all patients by using the dialysate which had glucose concentrations of 2,270 or 2,500 mg/dL. The dialysate-to-instilled ratio of glucose (D4/D0 ratio of glucose) and acetylcholine the D/P ratio of creatinine were calculated TSA HDAC from the data of PET. Effluent and plasma samples were collected from patients at the end-point of PET. Table 1 Clinical features of patients Number (male:female) 20 (12:8) Age (years) 55 ± 2 Underlying renal disease  Chronic glomerulonephritis

10  Diabetic nephropathy 2  Other/unknown 8 Peritoneum dialysis period (years) 4.7 ± 0.7 History of peritonitis (times) 0.4 ± 0.2 (0–2) Concentration of glucose in peritoneal dialysis effluent (mg/dL) 1,611 ± 68 Data are expressed as the mean ± SE Measurement of AM, mAM, CA125, glucose, and creatinine concentration Concentrations of AM and mAM in samples from effluent and plasma were measured by a one-step two-site immunoradiometric assay (IRMA) method using monoclonal antibodies (Cosmic Corporation, Tokyo, Japan). In addition, the mAM/AM ratio was calculated. Serum and effluent CA125 were measured by enzyme immunoassay (EIA) (Tosho Corporation, Tokyo, Japan). Serum and effluent glucose were measured by hexokinase and glucose-6-phosphate dehydrogenase methods. Serum and effluent creatinine levels were measured enzymatically (Mizuho Medy, Saga, Japan). Finally, the concentrations of AM, mAM and CA125 in effluent were examined for their relevance in a disease process such as diabetes.