The effect of mannose binding serum levels on dialysis related peritonitis and catheter related bacteremia

Objective: Mannose binding lectin (MBL) takes part in innate immunity throug opsonisation and complement activation. MBL deficiency is associated with some infections and autoimmune disorders. This study focused on functional MBL deficiency and its effect on risk of dialysis related peritonitis and tunneled/cuffed catheter related bacteremia in patients with end stage renal disease. Material and Method: 51 patients on chronic peritoneal dialysis (PD) program and 31 patients under maintenance hemodialysis (HD) who had tunneled/cuffed hemodialysis catheters as vasculer access (total 82) were included in this study. Serum MBL level measurements were performed by Elisa technique. Results: The mean value for serum MBL level in patient groups PD and HD and healthy controls were 2536,5 ng/ml, 2088,7 ng/ml 1924 ng/ml respectively. Difference of serum MBL level was not significant among groups. Serum MBL value was negatively correlated to the number of peritonitis episodes in PD group (p=0,019). MBL deficiency was not associated with high incidence of peritonitis (>0,67 episodes/year) in peritoneal dialysis patients. The surveillance of catheter associated blood stream infection for tunneled/cuffed hemodialysis catheters in our center was 2,07 episodes/1000 catheter days. An association with functional MBL deficiency and incidence of catheter related bacteremia was not observed. Conclusion: MBL deficiency was not associated with high incidence of dialysis related peritonitis and catheter related bacteremia amongs patients in our center. On the other hand serum MBL value was negatively correlated to the number of peritonitis episodes in PD group. New studies with greather sample size might indicate the potential effect of MBL deficiency on dialysis related peritonitis.