Clinical Implications of Membrane Transport Characteristics on the Adequacy of Fluid and Solute Removal

Abstract

It is important to identify the peritoneal transport characteristics of each patient and to guide the peritoneal therapy accordingly. High transporters on CAPD are prone to protein malnutrition because of increased protein losses and suppression of appetite with excessive carbohydrate loading from the peritoneal cavity. Anephric high transporters often do better on short-cycle therapies. Anephric low transporters of large size cannot readily meet clearance targets on standard peritoneal dialysis prescriptions. In patients with low rates of peritonitis, changes in peritoneal dialysis prescriptions are more commonly dictated by changes in residual renal function rather than changes in peritoneal transport.