Effect of diabetes on peritoneal function assessed by personal dialysis capacity test in patients undergoing CAPD.
BACKGROUND
We evaluated differences in individual peritoneal membrane transport function and nutritional status in patients with diabetes mellitus (DM) and nondiabetic (non-DM) patients on continuous ambulatory peritoneal dialysis (CAPD).


METHODS
We used a newly developed peritoneal function test, personal dialysis capacity, in 88 patients (44 DM and 44 non-DM) on CAPD for 1 to 210 months. Sex, age, past history of peritonitis, and duration of CAPD were matched in DM and non-DM patients.


RESULTS
Serum albumin (mean +/- SEM) was lower in DM compared with non-DM patients: 3.0 +/- 0.1 g/dL (30 +/- 1 g/L) versus 3.5 +/- 0.1 g/dL (35 +/- 1 g/L), P < 0.001. Peritoneal area and dialysis protein loss were greater in DM versus non-DM patients. In multiple linear regression analysis, the only independent predictor of serum albumin in patients with DM was dialysis protein loss. In contrast, age, past history of peritonitis, duration of CAPD, caloric intake, protein nitrogen appearance and protein catabolic rate, and residual renal function did not correlate with serum albumin in DM patients. In non-DM patients, age, duration of CAPD, and past history of peritonitis, but not dialysis protein loss, were independent predictors of serum albumin. There was a significant correlation in DM patients, but not in non-DM CAPD patients, between dialysis protein loss and urinary excretion of protein (r = 0.866, P = 0.0005).


CONCLUSIONS
In this multicenter study, peritoneal membrane transport and peritoneal protein permeability were significantly higher in DM than in non-DM patients. Hypoproteinemia in DM patients is attributable to the high permeability of the peritoneal membrane undergoing CAPD.
Nakamoto
Hidetomo
H
Department of Nephrology, Saitama Medical School, and PDC Study Group in Japan, Saitama, Japan.
Imai
Hirokazu
H
Kawanishi
Hideki
H
Nakamoto
Masahiko
M
Minakuchi
Jun
J
Kumon
Shinichi
S
Watanabe
Syuichi
S
Shiohira
Yoshiki
Y
Ishii
Takeo
T
Kawahara
Toshihiko
T
Tsuzaki
Koichi
K
Suzuki
Hiromichi
H
D000367:Age Factors; D000419:Albuminuria / Q000097:blood / Q000503:physiopathology; D000704:Analysis of Variance; D001692:Biological Transport / Q000502:physiology; D001798:Blood Proteins / Q000378:metabolism; D003920:Diabetes Mellitus / Q000097:blood / Q000503:physiopathology* / Q000652:urine; D015314:Dialysis Solutions / Q000737:chemistry / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000379:methods / Q000706:statistics & numerical data; D010537:Peritoneum / Q000503:physiopathology*; D010538:Peritonitis / Q000209:etiology / Q000503:physiopathology; D011507:Proteinuria / Q000097:blood / Q000503:physiopathology; D012044:Regression Analysis; D012709:Serum Albumin / Q000378:metabolism; D012737:Sex Factors
D001798:Blood Proteins; D015314:Dialysis Solutions; D012709:Serum Albumin