CCN2 and Peritoneal Fibrosis: Peritoneal membrane longevity in PD is limited by glucotoxicity, which is hypothesized to be secondary to the degradation of glucose that changes the intracellular NADH/NAD + ratio resulting in pseudohypoxia, and, thus, inducing peritoneal fibrosis via the stimulation of the Hypoxia-Inducible Factor-1 gene among other genes, such as Transforming Growth Factor Beta, Connective Tissue Growth Factor, Plasminogen Activator Inhibitor-1, and VEGF [15].