Continuous Ambulatory Peritoneal Dialysis腹膜炎の経過における透析液中ブドウ糖残存量と蛋白喪失量の推移

抄録

Solute permeability of the peritoneum accelerates considerably in continuous ambulatory peritoneal dialysis (CAPD)-related peritonitis. Residual dextrose (RD) (g/bag) and the amount of total protein loss (LP) (g/bag) in the effluent of dialysate were measured during the clinical course of 21 cases of CAPD-related peritonitis as markers of deranged peritoneal permeability. The following were the results obtained: 1) In 15 cases of intraluminal infection (simple peritonitis by microorganism contamination through the lumen of a peritoneal catheter), RD decreased on day 1 (p< 0.001) and day 3 (p< 0.001) after the onset of peritonitis, and LP increased on day 1 (p< 0.001) and day 3 (p< 0.01), compared to the values of the non-infected phase. Both parameters were restored on day 7 and day 14 by adequate therapeutic maneuver. 2) In 6 cases of periluminal infection (peritonitis caused by an organic lesion of infection along the peritoneal catheter), RD and LP persisted even on day 7 (p<0.01), and recovered 10 days after surgical removal of the peritoneal catheter with simultaneous catheter replacement. It is concluded that both RD and LP are valuable markers in the evaluation of the clinical course of CAPD-related peritonitis, and are useful in deciding on therapeutic intervention.