Follow-up of peritoneal clearances in patients undergoing continuous ambulatory peritoneal dialysis

Abstract

Continuous ambulatory peritoneal dialysis (CAPD) might result in peritoneal membrane changes. First, CAPD exposes essentially continuously the peritoneum to peritoneal dialysis solutions. Such solutions differ from the usual extracellular fluid bathing peritoneal tissues. Second, this technique may be complicated by an increased frequency of peritonitis when compared to intermittent peritoneal dialysis. We undertook a prospective study of patients undergoing CAPD to determine if there were decreases in peritoneal clearances and if the peritoneal microcirculation maintained its responsiveness to nitroprusside. Peritoneal transport, as assessed by the clearances of urea, creatinine, inulin, and dialysate protein concentration, with and without nitroprusside addition in the dialysis solution, is unchanged in patients undergoing CAPD for up to 1 year, despite frequent episodes of peritonitis.

Functional Characteristics of the Peritoneal Membrane in Long-Term Continuous Ambulatory Peritoneal Dialysis

“…Neither Rubin et al [19] in a longitudinal study in 12 patients with a follow-up of maximal I year nor Nikolakakis et al [4] reported significant changes in ultrafiltra tion. However, loss of fluid removal capacity in CAPD patients has been found in several other studies with an incidence varying from 1.3 to 100% [5, 25 30-34].…”

Peritoneal Abnormalities during Infectious Episodes of Continuous Ambulatory Peritoneal Dialysis

“…Frequent episodes of peri tonitis are associated with a loss of lean body mass as assessed by total body potassium measurements [II]. lilumenkrantz [5] suggests these protein losses may be pro longed, whereas in studies reported elsewhere, protein con centration during hourly exchanges had returned to control values I week follow ing an episode of peritonitis [12]. The studies reported here were not designed to determine when protein losses in dialysate returned to control values fol lowing an episode of peritonitis.…”

In vivo Use of Activated Charcoal as a Sorbent in Continuous Ambulatory Peritoneal Dialysis

“…Clinical peritonitis in CAPD patients is associated with decreases in ultrafiltration, increases in protein losses in dialysate, and increases in net glucose absorption [14,21], Return to normal functions is associated with recovery of normal transport characteristics [21,22]. Verger et al [14] also injured the mésothélium in rats using a drying technique and found similar decreases in ultrafiltration and increases in both protein dialysate and net glucose absorption.…”