The first weeks on peritoneal dialysis: effects on clinical parameters

Initiation of peritoneal dialysis (PD) induces several changes both locally in the peritoneum and systemically. We performed a pilot study to generate insights into the early clinical and systemic changes after catheter insertion and the first weeks of PD. The study included 11 new PD patients (7 men, 4 women). The study period started just before implantation of the Tenckhoff catheter and finished 6 weeks after the start of PD. All patients were treated with lactate-buffered dialysis solutions. Clinical parameters, routine laboratory tests and markers of systemic inflammation were determined. The mean (+/- standard deviation) age of the patients was 52.6 +/- 12.1 years, mean weight was 81.3 +/- 14.7 kg, and mean blood pressure was 143.3/ 87.8 +/- 18.5/8.2 mmHg. Weight and blood pressure did not change significantly during the first weeks of PD. Throughout the study, 24-hour urine production declined by 6.9 mL/day (p = 0.006). Daily residual creatinine clearance (CCr) decreased by 0.036 mL/min (p = 0.008). High-sensitivity C-reactive protein (hs-CRP) was significantly higher in patients who had undergone hemodialysis before the start of the study (p < 0. 0001) and declined during the study in that group (p = 0.001). No significant change in hs-CRP was found in the group that started dialysis with PD. In this pilot study, we found no significant changes in the clinical parameters of weight and blood pressure during the first weeks of PD. However, urine production and residual CCr declined significantly during the study period, starting from the moment of catheter insertion. Levels of the systemic inflammatory marker hs-CRP were higher in patients who had previously undergone hemodialysis; its level in those patients decreased after hemodialysis ended.