Functional characteristics of the peritoneal membrane in long-term continuous ambulatory peritoneal dialysis.
Peritoneal transport characteristics of 20 long-term (LT) patients with a mean duration on continuous ambulatory peritoneal dialysis (CAPD) of 60 months were compared with those of 20 matched patients who recently started (RS) CAPD (mean 39 days, range 11-63). Mass transfer area coefficients (MTC) of creatinine, glucose and inulin were higher in the LT group than in the RS group (12.1 versus 9.2 ml/min, p less than 0.01; 9.9 versus 8.3 ml/min, p less than 0.05; 4.1 versus 3.5 ml/min, p less than 0.05). The MTC of alpha 2-macroglobulin were lower in the LT group (13 versus 25 microliters/min; p less than 0.01). The size selectivity of the membrane for the transport of macromolecules, determined as protein MTC ratios, showed a more restricted passage for macromolecules in the LT group. Net fluid removal using glucose 3.86% was lower in the LT patients (487 versus 826 ml/4 h; p less than 0.001). The results indicate the development of a larger effective peritoneal surface area combined with a less permeable peritoneal membrane after many years of CAPD.
Struijk
D G
DG
Department of Medicine, University of Amsterdam, The Netherlands.
Krediet
R T
RT
Koomen
G C
GC
Hoek
F J
FJ
Boeschoten
E W
EW
vd Reijden
H J
HJ
Arisz
L
L
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005947:Glucose / Q000032:analysis; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007674:Kidney Diseases / Q000503:physiopathology / Q000628:therapy*; D007700:Kinetics; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D012709:Serum Albumin / Q000032:analysis; D014508:Urea / Q000032:analysis; D000511:alpha-Macroglobulins / Q000032:analysis; D001613:beta 2-Microglobulin / Q000032:analysis
D007074:Immunoglobulin G; D008567:Membranes, Artificial; D012709:Serum Albumin; D000511:alpha-Macroglobulins; D001613:beta 2-Microglobulin; D014508:Urea; D005947:Glucose