A prospective study of transperitoneal transport in patients undergoing peritoneal dialysis.

Abstract

A prospective one-year follow-up study of the functional characteristics of the peritoneal membrane was conducted in 20 peritoneal dialysis patients. Ten patients had at least one episode of peritonitis during the follow-up period. Changes in the transperitoneal transport of small solutes were evaluated by the mass transfer area coefficients (urea, creatinine, and glucose), ultrafiltration sieving coefficients (urea and creatinine), and peritoneal equilibration test results. Changes in the capacity of the peritoneal membrane to transport macromolecules were evaluated by means of albumin mass transfer rates. Finally, changes in transperitoneal water transport were evaluated by means of the ultrafiltration properties and the lymphatic flow rates. After one year of follow-up, transport of water and the investigated solutes had not changed significantly. Even episodes of peritonitis had no permanent influence on the transport function of the peritoneal membrane. The intraperitoneal residual volumes before instillation were significantly larger in patients who developed peritonitis during the follow-up period compared to patients who did not. Over a one-year period, no changes in peritoneal membrane characteristics could be demonstrated. A large residual volume of dialysate may be a marker of increased risk of getting peritonitis.