[Prognosis and changes of peritoneal function in CAPD and APD patients]

Prevention of peritoneal function is a major critical factor in the continuation of CAPD treatment. Eighty-nine CAPD and APD patients were investigated for 7 years or 9 months, respectively. The purpose of the present study was (a) to determine the levels of solute in the blood, i.e. serum creatinine (s-Cr), BUN, hANP, Lp (a) and electrolytes, and urinary volume, water removal and dextrose contents in the dialysate, and (b) to analyze these parameters according to categories such as sex, age, presence of DM and frequency of peritonitis in such patients. Peritoneal function of 15 APD patients was also examined by peritoneal equilibration test (PET) and urea kinetics. Excretion of urine in female CAPD patients was higher than that in male patients. The levels of BUN and s-Cr in male CAPD patients increased gradually during the clinical course due to systemic muscular volume and/or loss of urinary excretion. Although there were no significant changes in the levels of solute in the blood between the ages of more or less than 65 years of CAPD patients, the residual renal function rapidly declined in patients more than 65 years of age. CAPD patients who had DM showed a rapid decline in urinary volume, and an increase in Lp(a) and ultrafiltration. The patients who had a frequent episode of peritonitis showed a decrease in water removal with increase in the concentration of dextrose in dialysate. There was a significant correlation between the levels of Ccr and those of KT/V in APD patients after the correction of KT/V with dwell time of dialysate storage in the abdominal cavity. It appears that several factors, such as sex, age, presence of DM and frequency of peritonitis, may be important factors in the maintenance of CAPD for long periods.