Evidence map›Paper›PMID 41108377›Full record

ArticlePediatric nephrology (Berlin, Germany)2026

Neutrophil extracellular traps drive peritoneal inflammation and tissue remodeling in pediatric peritoneal dialysis.

Charlotte Maria Dücker, Martin Herrmann, Susanne Boettcher, Sarah Bauer-Carmona, Raphael-Sebastian Schild, Lavinia Schönfeld, Laia Pagerols Raluy, Konrad Reinshagen, Claus Peter Schmitt, Maria Bartosova Medvid and 1 more

Abstract read
In one paragraph

Article in Pediatric nephrology (Berlin, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Charlotte Maria DückerDepartment of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Martin HerrmannDepartment of Pediatric Surgery, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany.
Susanne BoettcherDepartment of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Sarah Bauer-CarmonaHeidelberg University, Medical Faculty Heidelberg, Centre for Pediatrics and Adolescent Medicine, Clinic 1, Pediatric Nephrology, Heidelberg, Germany.
Raphael-Sebastian SchildDepartment of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Lavinia SchönfeldDepartment of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Laia Pagerols RaluyDepartment of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Konrad ReinshagenDepartment of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Claus Peter SchmittHeidelberg University, Medical Faculty Heidelberg, Centre for Pediatrics and Adolescent Medicine, Clinic 1, Pediatric Nephrology, Heidelberg, Germany.
Maria Bartosova MedvidHeidelberg University, Medical Faculty Heidelberg, Centre for Pediatrics and Adolescent Medicine, Clinic 1, Pediatric Nephrology, Heidelberg, Germany.
Michael BoettcherDepartment of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Michael.boettcher@medma.uni-heidelberg.de.ORCID http://orcid.org/0000-0003-4972-9866

Funding

DFG 446358093
6 · The paper itself

Abstract

backgroundPeritoneal dialysis (PD) sustains children with chronic kidney disease stage 5 (CKD5) but promotes peritoneal membrane remodeling. Neutrophil extracellular traps (NETs) orchestrate antimicrobial defense and sterile inflammation; their involvement in PD-induced transformation is unknown.

methodsForty-five children were enrolled in the International Pediatric Peritoneal Biobank. Peritoneal biopsies taken at PD initiation and after ≥ 12 months of low-glucose-degradation-product PD were compared with surgical biopsies from non-uremic peers. Histomorphometry quantified microvessel density, submesothelial thickness, leukocyte infiltration, collagen I/III, and NET markers (citrullinated histone H3, neutrophil elastase, myeloperoxidase). Dialysate and plasma collected every 2 months for 18 months were assayed for cell-free DNA, NET proteins, DNase1, and DNase1L3.

resultsAfter chronic PD, the peritoneum displayed doubled microvessel density, tripled submesothelial thickness, and marked immune-cell infiltration (all p < 0.01). NET structures were prominent in tissue, while dialysate and plasma concentrations of cell-free DNA, citrullinated histone H3, neutrophil elastase, and myeloperoxidase increased two- to fourfold versus baseline (p < 0.05). DNase1 levels correlated with membrane thickness (r = 0.46, p = 0.003) and DNase1L3 with vascular density (r = 0.51, p = 0.001), suggesting limited compensatory NET clearance.

conclusionsChronic PD elicits NET-driven sterile inflammation that parallels structural remodeling of the pediatric peritoneum. Supplementing PD fluids with exogenous NET-degrading enzymes may preserve membrane integrity and prolong PD suitability in children.

Indexed as

Extracellular TrapsPeritoneal DialysisPeritoneumPeritonitisAdolescentBiopsyChildChild, PreschoolDeoxyribonuclease IDialysis SolutionsFemaleHistonesHumansInfantKidney Failure, ChronicMaleDeoxyribonuclease IDialysis SolutionsHistonesChildrenDNase1 and DNase1L3Neutrophil extracellular trapsPeritoneal dialysis

Identifiers

PMID41108377
PMCPMC12852172

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.