Peritoneal fibrosis and its prevention

Peritoneal fibrosing syndrome (PFS) is composed of a wide spectrum of peritoneal alterations observed in patients under peritoneal dialysis (PD). Long-term peritoneal exposure to unphysiological PD solutions and recurrent bacterial peritonitis had been claimed as the most common causes predisposing to the development of PFS in a PD population. With the advances in molecular research, physicians and pathologists recognized that peritoneal injury and the accompanied accumulation of extracellular matrix (ECM) within the peritoneum are key events leading to PFS. Bioincompatible solution and it's related products, inflammatory mediators, growth factors as well as cytokines in the peritoneal cavity are contributing factors. Therapeutic strategies antagonizing these mediators and/or their downstream intracellular signalling pathways with either drug molecules or gene transfer may have potential for the prevention or treatment of PFS.