engleski

Peritoneal membrane function and dialysate leukocyte count

Petironitis remains the most serious complication in patients treated with continuous ambulatory peritoneal dialysis /Capdd). As an inflammatory process, it is an indicator of the immune system vascular and cellular response to the causative noxa. In most cases, it has a benign course, yer, morphologic alterations of the peritoneal membrane may occur even with complete clinical recovery. In spite of many studies, no consensus has yet been achieved about longtern effects alterations on the membrane function. Leukocyte count in dialysate was determined and peritoneal membrane function was assessed (urea and creatinine clearance, Kt/v, peritoneal equilibration test, protein loss by dialysate, and glucose absorption from dialysate) in 17 anuric patients on CAPD during 28 episodes of peritonitis. The dialysate leukocyte count was correlated with the results of peritoneal membrane functional testing. Then the results of peritoneal membrane functional testing recorder during 21 episodes of peritonitis in 12 patients were compared with the results recorded in the same group of patients during 21 testing procedures performed at least 3 months after recovery from peritonitis. During the cours of peritonitis, there was no statistically significant correlation of dialysate leukocyte count with any of the peritoneal membrane function parameters. Comparison of results obtained in the presence or obsence of peritonitis showed a statistically significantly greater protein loss via dialysate (7.92 + -3.97 g vs 5.61 plus, minus 1.63 g ; t=2.44, p<0.05) and higer glucose absorption from dialysate (726.87 + -217.83 mmol vs 606.84 + - 197.12 mmol ; t=2.65, p<0.01 ; 71, 59+-13.83% vs 62.09+-12, 84% ; t=2.76, p<0.01) during peritonitis. The rates of urea and creatinine clearance and Kt/V showed no significant differences. The results obtained suggest that is no significant correlation between dialysate leukocyte count and parameters of peritoneal membrane functional analysis during peritonitis. There is no uniform impact of peritonitis on clearance rates, ultrafiltration capacity of the peritoneal membrane, and loss of protein. With appropriate treatment and favorable outcome, impairments of the cellular response resolve very fast, while functional distrubances also do not persist much longer.

Continuous ambulatory peritoneal dialysis; peritoneal membrane function; peritonitis; dialyse leukocyte count

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