CA125: Holy Grail or a Poisoned Chalice

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Abstract
Identifying easily measurable markers that are of prognostic value in predicting membrane failure in peritoneal dialysis (PD) patients remains one of the major challenges. Facilitating this endeavour has always been the ease of sampling of drained peritoneal effluent within which, with the development of ever more sensitive measurement techniques, any number of mediators can be quantitated. Local production of these ‘factors’ (i.e. of peritoneal membrane or infiltrating leucocyte origin) would then theoretically, at least, allow changes to be correlated with clinical outcomes and thereby their usefulness as indicators of altered membrane status. So far then there is an attractiveness and inescapable logic to this type of approach that would predict that after almost 20 years of investigation (since the first measurements of prostaglandins in peritoneal effluent [1, 2]) there would now be sufficient data on a number of markers predictive of clinical and membrane-associated changes in these patients. Unfortunately, however, despite significant scientific endeavour (and as we will discuss a number of long-term clinical studies) we are really little nearer to identifying our holy grail.