Longitudinal change in peritoneal membrane function with continuous ambulatory peritoneal dialysis (CAPD) after peritonitis episodes.

Background: To assess changes in the peritoneal membrane after peritonitis episodes in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Methods: From 1989 to 2002, CAPD patients who had peritonitis episodes were enrolled. We used the peritoneal equilibration test (PET) and measured plasma creatinine (Cr) levels at 2 hours, and dialysate Cr and glucose levels at 0, 2, and 4 hours. In addition, the dialysate-to-plasma ratio of Cr (D/PCr) at 0, 2, and 4 hours, the ratio of glucose levels in the dialysate effluent and infused dialysate ((D/D0)G), the drained ultrafiltration (UF) volume at 4 hours, and the mass transfer area coefficient of Cr (MTAC) normalized for the body surface area were also calculated. D/PCr, (D/D0)G, UF volume, and MTAC were measured at the baseline and after 2 years, and the results were analyzed and compared. Results: Totally 27 patients were enrolled in the peritonitis group, including 17 males and 10 females. They had received CAPD for 71.23 28.13 months. Fortynine peritonitis episodes were noted during the study period. Twenty-four patients were enrolled as controls, including 9 males and 15 females. They had undergone CAPD for 55.83 25.94 months. The baseline and 2-year levels of D/PCr (0.66 0.11 vs. 0.62 0.10, p 0.05) showed no significant change. In the control group, there were no significant changes in D/PCr, (D/D0)G, MTAC, or UF volume. Conclusion: Peritonitis episodes affect the peritoneal membrane solute transport function in CAPD patients. (Chang Gung Med J 2004;27:29-34)