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- Title
Effect of diabetes and peritonitis on the peritoneal equilibration test.
- Authors
Lamb, Edmund J.; Worrall, Jill; Buhler, Reiner; Harwood, Steven; Cattell, William R.; Dawnay, Anne B.
- Abstract
Peritoneal equilibration tests (PET) were performed on 47 patients (15 diabetics) who had been on CAPD for 1 to 112 months. Among new patients on CAPD (1 to 3 months) with no history of peritonitis, diabetics had higher D/PCr than non-diabetics (P < 0.62). However, after ≥7 months of CAPD, in patients with ≤2 episodes of peritonitis, glucose and creatinine transport rates were lower (P < 0.05) in diabetic than non-diabetic patients. Among patients on CAPD for ≥7 months, creatinine (P < 0.05) and glucose transport (P < 0.01) were higher in patients with a history of ≥3 episodes of peritonitis than in those with ≤2 episodes. Drain volumes did not differ between any of the subgroups (all P > 0.05). The observations in patients newly established on CAPD were substantiated in a larger study of 55 non-diabetic and 35 non-insulin dependent diabetic patients. D/D0 glucose correlated with plasma glucose (r = 0.40, P < 0.02) in the diabetic group. Net ultrafiltration was reduced in hyperglycemic (P = 0.022) but not normglycemic diabetics (non-diabetics 231 ± 167 ml, hyperglycemic diabetics 127 ± 177 ml, normoglycemic diabetics 238 ± 159 ml). Creatinine clearance was higher in normoglycemic (P = 0.02) but not hyperglycemic diabetics (non-diabetics 6.8 ± 0.9 ml/min, hyperglycemic diabetics 7.4 ± 0.8 ml/min, normoglycemie diabetics 7.4 ± 0.7 ml/min). These data show that diabetes and peritonitis incidence should be borne in mind when interpreting results of the PET. We conclude that peritoneal membrane transport differs in non-insulin dependent diabetic patients and that ultrafiltration will be lower than is achievable in non-diabetic patients with the same glucose transport rate unless normoglycemia is maintained.
- Subjects
DIABETES; PERITONITIS; PEOPLE with diabetes; GLUCOSE; CREATININE
- Publication
Kidney International, 1995, Vol 47, Issue 6, p1760
- ISSN
0085-2538
- Publication type
Article
- DOI
10.1038/ki.1995.243