Role of macrophages in peritoneal dialysis-associated peritoneal fibrosis

Peritoneal dialysis (PD) can be used as renal replacement therapy when chronic kidney disease (CKD) progresses to end-stage renal disease. However, peritoneal fibrosis (PF) is a major cause of PD failure. Studies have demonstrated that PD fluid contains a significantly larger numbers of macrophages...

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Main Authors: Chenling Chu, Ying Huang, Luxi Cao, Shuiyu Ji, Bin Zhu, Quanquan Shen
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Renal Failure
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2025.2474203
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author Chenling Chu
Ying Huang
Luxi Cao
Shuiyu Ji
Bin Zhu
Quanquan Shen
author_facet Chenling Chu
Ying Huang
Luxi Cao
Shuiyu Ji
Bin Zhu
Quanquan Shen
author_sort Chenling Chu
collection DOAJ
description Peritoneal dialysis (PD) can be used as renal replacement therapy when chronic kidney disease (CKD) progresses to end-stage renal disease. However, peritoneal fibrosis (PF) is a major cause of PD failure. Studies have demonstrated that PD fluid contains a significantly larger numbers of macrophages compared with the healthy individuals. During PD, macrophages can secrete cytokines to keep peritoneal tissue in sustained low-grade inflammation, and participate in the regulation of fibrosis-related signaling pathways, such as NF-κB, TGF-β/Smad, IL4/STAT6, and PI3K/AKT. A series of basic pathological changes occurs in peritoneal tissues, including epithelial mesenchymal transformation, overgeneration of neovasculature, and abnormal deposition of extracellular matrix. This review focuses on the role of macrophages in promoting PF during PD, summarizes the targets of macrophage-related inhibition of fibrosis, and provides new ideas for clinical research on delaying PF, maintaining the function and integrity of peritoneum, prolonging duration of PD as a renal replacement modality, and achieving longer survival in CKD patients.
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publishDate 2025-12-01
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series Renal Failure
spelling doaj-art-347b1ffa9eed4e8991872799c3d5adb82025-08-20T03:05:45ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492025-12-0147110.1080/0886022X.2025.2474203Role of macrophages in peritoneal dialysis-associated peritoneal fibrosisChenling Chu0Ying Huang1Luxi Cao2Shuiyu Ji3Bin Zhu4Quanquan Shen5Department of Clinical Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, ChinaUrology & Nephrology Center, Department of Nephrology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, ChinaUrology & Nephrology Center, Department of Nephrology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, ChinaUrology & Nephrology Center, Department of Nephrology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, ChinaUrology & Nephrology Center, Department of Nephrology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, ChinaUrology & Nephrology Center, Department of Nephrology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, ChinaPeritoneal dialysis (PD) can be used as renal replacement therapy when chronic kidney disease (CKD) progresses to end-stage renal disease. However, peritoneal fibrosis (PF) is a major cause of PD failure. Studies have demonstrated that PD fluid contains a significantly larger numbers of macrophages compared with the healthy individuals. During PD, macrophages can secrete cytokines to keep peritoneal tissue in sustained low-grade inflammation, and participate in the regulation of fibrosis-related signaling pathways, such as NF-κB, TGF-β/Smad, IL4/STAT6, and PI3K/AKT. A series of basic pathological changes occurs in peritoneal tissues, including epithelial mesenchymal transformation, overgeneration of neovasculature, and abnormal deposition of extracellular matrix. This review focuses on the role of macrophages in promoting PF during PD, summarizes the targets of macrophage-related inhibition of fibrosis, and provides new ideas for clinical research on delaying PF, maintaining the function and integrity of peritoneum, prolonging duration of PD as a renal replacement modality, and achieving longer survival in CKD patients.https://www.tandfonline.com/doi/10.1080/0886022X.2025.2474203Peritoneal dialysisperitoneal fibrosismacrophageepithelial mesenchymal transitionpolarizationTGF-β/ Smad signaling pathway
spellingShingle Chenling Chu
Ying Huang
Luxi Cao
Shuiyu Ji
Bin Zhu
Quanquan Shen
Role of macrophages in peritoneal dialysis-associated peritoneal fibrosis
Renal Failure
Peritoneal dialysis
peritoneal fibrosis
macrophage
epithelial mesenchymal transition
polarization
TGF-β/ Smad signaling pathway
title Role of macrophages in peritoneal dialysis-associated peritoneal fibrosis
title_full Role of macrophages in peritoneal dialysis-associated peritoneal fibrosis
title_fullStr Role of macrophages in peritoneal dialysis-associated peritoneal fibrosis
title_full_unstemmed Role of macrophages in peritoneal dialysis-associated peritoneal fibrosis
title_short Role of macrophages in peritoneal dialysis-associated peritoneal fibrosis
title_sort role of macrophages in peritoneal dialysis associated peritoneal fibrosis
topic Peritoneal dialysis
peritoneal fibrosis
macrophage
epithelial mesenchymal transition
polarization
TGF-β/ Smad signaling pathway
url https://www.tandfonline.com/doi/10.1080/0886022X.2025.2474203
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AT shuiyuji roleofmacrophagesinperitonealdialysisassociatedperitonealfibrosis
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