Evolution of clinical parameters and peritoneal function in a cohort of CAPD patients followed over 7 years

The clinical results and the long-term evolution of some peritoneal transport characteristics were retrospectively analysed in a cohort of 23 patients who had been maintained continuously on CAPD for at least 7 years. Several clinical and biological results like blood pressure, peripheral nerve conductivity, total protein, and serum phosphorus showed relatively stable values. On the other hand increases were noted in body weight, consumption of antihypertensive drugs; creatinine, serum calcium and parathormone concentration. Haematocrit, cholesterol, and triglycerides significantly increased during the first 2-4 years but returned to the predialysis values after 5-7 years. In contrast with patients never exposed to acetate dialysate, there was a continuous loss of peritoneal ultrafiltration from 1000 ml/day to 780 ml/day (P < 0.05) in patients who had been treated with acetate. However, peritoneal creatinine clearances and the D/P creatinine ratios remained constant. The Kt/V urea index declined from 0.88 +/- 0.8 during the first year to 0.62 +/- 0.06 after 7 years (P < 0.001). This was due to a decline in contribution of the residual renal Kt/V urea index from 21.6% at the start to less than 3% after 7 years. A negative correlation between the Kt/V urea index per year and the hospitalization rate and a positive correlation with the peripheral nerve conductivity were found. In conclusion, the long-term peritoneal diffusive capacity can remain stable over 7 years in CAPD; in some patients a continuous fall in peritoneal ultrafiltration appears which can be counterbalanced by stimulation of their daily diuresis with high doses of frusemide.(ABSTRACT TRUNCATED AT 250 WORDS)