Abstract
In CAPD, serum albumin is useful a predictor of morbidity. Changes in serum albumin depend greatly on peritoneal permeability in stable cases. Moreover, it is inevitable not only for peritoneal permeability to rise annually but also for hypoalbuminemia to advance. In this study, stable non-diabetic cases were classified into stages based on serum albumin and the D/P of creatinine (Cr-D/P). Serum albumin was divided into 3 stages: over 4.0g/dl, 4.0-3.5g/dl and below 3.5g/dl, each of which was further divided into 2 stages, at a boundary of Cr-D/P 0.8, as Noproblem, Stable, Pre-failure and Failure groups. As the CAPD period increased, the stage advanced to Pre-failure in an average of 37±28 months and reached the Failure stage in an average of 45±21 months. The peritoneal permeability of the Failure group rose to a serum albumin 3.2±0.3g/dl, Cr-D/P 0.86±0.20, β2-microglobulin-D/P 0.21±0.10, and the dialysate protein to 5.3±2.0g/day. Moreover, the morbidity rate of the Failure group was higher. As a result, for the cases in the Pre-failure group with a serum albumin of 4.0-3.5g/dl and Cr-D/P over 0.8, peritoneal function should be closely observed; and for those in the Failure group whose serum albumin fell below 3.5g/dl and Cr-D/P was over 0.8, even withdrawal of the CAPD therapy should be taken into account.
