The investigation of the relationship between PAİ-1 gene changes and fibrosis in peritoneal dialysis patients

Peritoneal fibrosis (PF) is a pathological process that leads up to encapsulated peritoneal sclerosis (EPS), which is a complication with high mortality rate, in peritoneal dialysis (PD) patients. PAI-1 (Plasminogen Activator Inhibitor-1) is an important molecule featured in the development of fibrosis. It has been shown in the literature that PAI-1 gene changes are associated with fibrosis in many tissues and organs. However, PAI-1 gene changes in PF patients have not been investigated. In this study, PAI-1 4G/5G polymorphism was examined by reverse hybridization, and all coding exon and exon-intron components of the PAI-1 gene (SERPINE1) were examined by sequence analysis, in 25 patients undergoing PD treatment, in order to identify PAI-1 gene changes and to provide treatment modification in patients with predisposition before fibrosis develops. Patients were divided into two groups: those with suspicion of PF or those with a high probability of developing PF (36%) and those with a low probability of developing PF (64%). There was no significant difference between the two groups in findings such as PET, Kt/V, the content of the PD solution used, and having peritonitis. There was also no significant difference in genotype distribution of PAI-1 4G/5G polymorphism between the two groups (p=1,000). A total of 8 gene changes (rs2227660, rs2227668, rs2854233, rs41281004, rs61553169, rs368413856, rs2227684) were detected by sequence analysis, one of which was exonic (rs6092). When genotype distributions of these changes were examined, no significant difference was found between the two groups. In conclusion, this study did not reveal a PAI-1 gene change predisposing to peritoneal fibrosis. There is a need for further studies involving other molecules responsible for PF pathogenesis and multiple mutation screening techniques with larger patient populations in patients undergoing long-term PD treatment.