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. Forty-nine 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), (D/D0)G (0.37 +/- 8.45 vs. 0.43 +/- 7.71, p<0.05), and MTAC (9.36 +/- 3.53 vs. 8.08 +/- 3.41, p<0.05) showed significant changes, but UF volume (253.70 +/- 224.43 vs. 311.54 +/- 186.71 ml, 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.