Two years on continuous ambulatory peritoneal dialysis--does it change peritoneal transport?

We investigated changes in peritoneal transport in patients treated at least 2 years with continuous ambulatory peritoneal dialysis (CAPD). The study included 28 patients (21 men, 7 women; CAPD duration: 24.0 - 28.3 months) who underwent peritoneal equilibration tests (PETs) at 3-month intervals for up to 24 months (group 24mPET). The PET results obtained at 24 months were compared to the results of the first PET taken in the same group (PET1, 0.03 - 15.86 months) and to the results of groups 1mPETand 6mPET. Group 1mPETconsisted of 41 patients--among them 14 patients (9 men, 5 women) from group 24mPET--who underwent a PET during the first month of CAPD. Group 6mPET consisted of 60 patients--among them 21 patients (15 men, 6 women) from group 24mPET--who underwent a PET at months 5 - 7 of CAPD. In analyzing paired data, we observed a significant reduction in vascular-to-mesothelial peritoneal transport (V --> M PT) in the entire group and in men. In analyzing unpaired data, we observed a reduction in V --> M PT between the 24mPET (n = 28) group and the 6mPET (n = 60) group [dialysate-to-plasma (D4/P2) creatinine: 0.54 +/- 0.18 vs. 0.65 +/- 0.19, p = 0.013]. Distribution of low, low-average, high-average, and high transporters did not vary among the groups, except in the case of low creatinine transporters, who represented 47% of the 24mPET group and 23% of the 6mPET group (p = 0.046). We conclude that in patients (men) treated with CAPD at least 2 years, V --> M PT decreases, increasing the percentage of low creatinine transporters and having no significant influence on dialysate drain volume. Peritoneal transport of glucose is stable over a 2-year period.