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Study wrapper · #720

MOTS-c is associated with oxidative stress and arterial stiffness in peritoneal dialysis patients: a pilot study.

Musolino M, Roumeliotis A, Roumeliotis S, et al. International urology and nephrology. 2026.
MixedOtherMentions: MOTS-c

Editor's note

This small pilot in 32 peritoneal-dialysis patients measured MOTS-c across serum, urine, and dialysate and correlated it with oxidative stress and arterial stiffness. The findings are mixed and compartment-specific: higher urinary MOTS-c went with lower oxidative stress but greater arterial stiffness, while higher dialysate MOTS-c tracked with a better vascular profile. With 32 participants and no follow-up, this is hypothesis-generating and correlational; it cannot establish whether MOTS-c is protective, compensatory, or simply a marker. The authors themselves frame it as a proposed "mitochondrial-vascular axis." Weight it lightly: a directionally inconsistent pilot in a niche population, useful mainly for flagging that MOTS-c compartmentalisation in uraemia deserves larger study.

Plain-language abstract

People on peritoneal dialysis (a home kidney-replacement therapy) face high cardiovascular risk driven partly by oxidative stress and stiff arteries. This small pilot in 32 stable patients measured MOTS-c, a mitochondria-derived peptide, in three places: blood, urine, and the used dialysis fluid. The results were not simple. Higher MOTS-c in urine went along with less oxidative stress (a possible protective sign) but also with stiffer arteries. Meanwhile, higher MOTS-c in the dialysis fluid was linked to healthier, less stiff blood vessels and lower blood pressure. Because the study looked at everyone at a single moment and included only 32 people, it cannot tell whether MOTS-c is helping, responding to injury, or just marking it. The authors suggest a new "mitochondrial-vascular axis" worth exploring. For now this is an early, mixed signal that raises questions rather than answering them, and much larger studies would be needed.