Abstract
The factors affecting electrolyte removal were studied in eight patients during continuous ambulatory peritoneal dialysis (CAPD). There was a highly significant correlation between ultrafiltration volume (UFV) and the amounts of sodium or chloride removed. Mass transfer of sodium and chloride underwent a four-fold increase with the use of 4.25% dextrose solution compared with that using 1.5% solution, along with a corresponding increase in UFV. On the other hand, mass transfers of potassium, inorganic phosphate and magnesium were increased by 1.3, 1. 4 and 2.3 times, respectively using 4.25% solution, compared with 1.5% solution.Dialysate to serum concentration ratios of various electrolytes were significantly lower in 4.25% solution exchanges than in those using 1.5% dextrose, indicating that electrolyte-poor ultrafiltrate was moved into the peritoneal cavity with the use of hypertonic dialysate.This fact must be kept in mind in cases receiving frequent exchanges of hypertonic solution, which causes hypernatremia.A negative calcium mass transfer was noted with the use of 4.25% solution. The net removal of magnesium was thought to be small, resulting in a gradual increase of serum magnesium concentration.A dialysate containing a lower magnesium and possibly higher calcium concentration could be made available to improve mineral homeostasis.
