RESUMO
Three hundred eighty-eight sequential reverse dextrose clearances (RDC) have been performed in 61 unselected patients (12 of whom were diabetics), whose mean age was 54 years (30-79). They were treated for a mean time of 23 +/- 12 months (0-60); the total observation time was 1,440 months. One hundred forty-two episodes of peritonitis were registered, producing a peritonitis incidence of 1 episode per 10.2 patient months. The RDC values are significantly inversely related to dwell-time and show a tendency to increase over time; they never, however, reach statistical significance. Age of patients, episodes of peritonitis and primary renal disease (diabetes) had no influence. It is important to underline the significant inverse relationship between ultrafiltration and residual diuresis. Unknown mechanisms regulate this relationship.
Assuntos
Glucose/farmacocinética , Falência Renal Crônica/terapia , Diálise Peritoneal Ambulatorial Contínua , Adulto , Idoso , Líquido Ascítico/metabolismo , Nefropatias Diabéticas/terapia , Feminino , Humanos , Falência Renal Crônica/sangue , Masculino , Taxa de Depuração Metabólica , Pessoa de Meia-Idade , Concentração Osmolar , Peritonite/sangueRESUMO
To investigate if age of patients, time on CAPD, episodes of peritonitis, or systemic illness (diabetes) may affect the permeability of the peritoneal membrane to small solutes, 51 patients (eight diabetic) 57.2 +/- 9.4 years of age undergoing long-term CAPD were enrolled in a prospective study of peritoneal clearances (PC), started in January 1982. The studies were repeated, when possible, every 6 months after peritonitis episodes. The results were divided according to osmolality of solutions and dwell time. The age of patients had no influence on results. Significantly positive correlations were found between PC (1.36%) of creatinine, uric acid, phosphate, and time on CAPD. Uric acid PC (3.86%) correlated directly with time on CAPD. The PC in diabetic and nondiabetic patients were similar. Patients who had more than three episodes of peritonitis showed PC similar to those observed in patients who had less than three episodes, despite a longer time on CAPD. The stability of PC in patients undergoing long-term peritoneal dialysis suggests that CAPD may permit effective dialysis over many years.
Assuntos
Diálise Peritoneal Ambulatorial Contínua , Peritônio/metabolismo , Peritonite/metabolismo , Adulto , Fatores Etários , Idoso , Creatinina/metabolismo , Diabetes Mellitus/metabolismo , Humanos , Pessoa de Meia-Idade , Concentração Osmolar , Diálise Peritoneal Ambulatorial Contínua/efeitos adversos , Permeabilidade , Fosfatos/metabolismo , Estudos Prospectivos , Fatores de Tempo , Ácido Úrico/metabolismoRESUMO
The transmembrane transfer of calcium during hemodialysis is related to many factors (calcium gradient, plasma volume flow, plasma concentration of phosphate). During biofiltration the high ultrafiltration rate reduces the net transfer of calcium from dialysate to patient. Prolonged metabolic alkalosis occurs during biofiltration, lowering the ionized calcium/total calcium ratio. These two factors may stimulate PTH secretion, with negative long-term effects in dialysis bone disease.
