A low CA++ level in effluent as a risk factor for the peritonitis in CAPD patients

In vitro, some studies revealed the importance of the CA++ level in peritoneal macrophage functions in CAPD patients. We therefore retrospectively studied the relationship between the frequency of peritonitis and the concentration of Ca, Ca++, Interferon-r (IFN-gamma), Interleukin-1B (IL-1B) in the Pd effluent. Samples were taken during a peritonitis-free period. In a group of patients without peritonitis, the mean Ca++ level in the Pd effluent was 2.25 +/- 0.20 mEq/L, while in the other group with frequent episodes of peritonitis (more than one episode per 20 patient-months), the mean Ca++ level in PD effluent was 2.01 +/- 0.13 mEq/L which was significantly lower than the former (p less than 0.05). The mean Ca concentration in Pd effluent was also lower in the group with the high frequent peritonitis than the peritonitis-free group, but not significantly. The level of IFN-gamma is lower and IL-1B is higher in the group with frequent peritonitis than in the peritonitis-free group, although these differences were not significant. These evidences suggest that lower Ca++ level in the effluent of the frequent peritonitis group may impair the peritoneal macrophage function and peritoneal cell-mediated immune function and may increase a risk of the peritonitis. These results may offer a new approach for prophylaxis of peritonitis in CAPD patients.