Quantification and characterization of protein loss in continuous ambulatory peritoneal dialysis.
OBJECTIVE
Dialysate protein loss is involved in the etiology of hypoalbuminemia and malnutrition on CAPD. There is no information regarding the peritoneal transport of proteins in neither Mexican nor LatinAmerican CAPD patients. Therefore, the aim of this study was to quantify and characterize the peritoneal membrane transport of albumin (Alb), IgG, IgA, and IgM in CAPD patients. In addition, factors associated to protein losses were investigated.


METHODS
Thirty-seven CAPD patients were randomly selected and subjected to a standard peritoneal equilibration test (PET). Alb, IgG, IgA, and IgM were measured during the PET in both serum and dialysate.


RESULTS
Dialysate IgM was not detected with the employed nephelometry method. A significant continuous and gradual increasing pattern in Alb, IgG and IgA losses was observed throughout the PET. During the PET, patients with the fastest transport type displayed the lowest serum concentration of Alb (but not Igs) and the greatest dialysate loss of all the assayed proteins. The strongest predictor for Alb, IgG, and IgA losses was peritoneal transport rate in both the univariate and multivariate analyses.


CONCLUSIONS
Peritoneal Alb, IgG, and IgA losses in Mexican CAPD patients are mainly dependent on peritoneal transport rate and dialysate dwell-time.
Cueto-Manzano
A M
AM
Unidad de Investigación Médica en Epidemiología Clínica, Hospital de Especialidades, CMNO, IMSS, Guadalajara, Jal. a_cueto_manzano@hotmail.com
Gamba
G
G
Correa-Rotter
R
R
D000328:Adult; D000418:Albumins / Q000378:metabolism*; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000378:metabolism*; D007074:Immunoglobulin G / Q000378:metabolism*; D007075:Immunoglobulin M / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory
D000418:Albumins; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M