Abstract
We introduced peritoneal dialysis (PD) to a 10 year old girl with MELAS, who had been suffering from end-stage renal disease. When she became critically ill with congestive heart failure due to renal dysfunction, hemodiafiltration using bicarbonate-buffered dialysate was performed. PD was consecutively started after the informed consent was obtained from her parents. Her systemic circulation improved almost completely with these procedures. Although we wondered about aggravation of mitochondrial respitatory status by loading lactate-buffered dialysate for a long period of time, unusual rise of lactate and pyruvate in her blood has not been observed at all. Her clinical condition is becoming fairly well after the continuance of PD for one year and nine months. The family has no trouble with manipulation of PD at home, and visits our outpatient department regularly.
