Discrepancy between solute transport rate and drain volume in CAPD patients with ascites

The ascites in the chronic renal failure patient is often difficult to treat and becomes intractable. Continuous ambulatory peritoneal dialysis (CAPD), as a maintenance therapy, is effective in the removal of ascites and may become a good alternative in dialysis therapy. The aim of this study was to evaluate the peritoneal membrane transport characteristics and ultrafiltration rate in CAPD patients who had preexisting ascites. Seven CAPD patients (6 male, 1 female; mean age 43 +/- 11 years) were included. The causes of ascites were liver cirrhosis (n = 4), hemodialysis-associated process (n = 2), and heart failure (n = 1). A peritoneal equilibration test (PET) using 2.5% dialysate was performed by the standard method at ten days after starting CAPD. The solute transport rate [dialysate glucose ratio (D/D6) and dialysate-to-plasma creatinine concentration ratio] showed high (n = 5) or high average (n = 2) transport. In 5 patients with high transport, PET showed a discrepancy between solute transport rate and drain volume. In spite of the high transport rate, the drain volume was greater than expected and corresponded to the area of low average or high average solute transport rate. Considering adequate solute clearance and good ultrafiltration, CAPD is an effective treatment in end-stage renal disease patients with intractable ascites.