Re. Reddingius et al., THE SERUM COMPLEMENT-SYSTEM IN CHILDREN ON CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS, Peritoneal dialysis international, 13(3), 1993, pp. 214-218
Objective: During continuous ambulatory peritoneal dialysis (CAPD), th
e loss of complement factors via the dialysate may cause complement de
ficiencies. This hypothesis was tested in a group of children treated
with CAPD. Design: Classical (CH50) and alternative (AP50) complement
activity and serum levels of factors C1q, C3, C4, C3d, B, D, and P in
CAPD patients were compared to normal controls and to children with pr
eterminal renal failure. Setting: Patients were seen in a university h
ospital; normal controls were seen in an outpatient clinic of a genera
l hospital. Patients: A group of 22 children on CAPD was compared to a
normal control group of 44 children and to a group of 12 children wit
h preterminal renal failure with a creatinine clearance below 25 mL/mi
n/1.73 m2. Results: CH50, AP50, C3, and B were not significantly diffe
rent from the control group in both the CAPD and preterminal groups. F
actors C1q (p=0.01) and C4, C3d, D, and P (p<0.001) were higher in the
CAPD group in comparison to the normal control group. The factors D (
p<0.001) and P (p=0.02) were also elevated in the preterminal group. F
or the measured factors there was no significant difference between th
e CAPD group and the preterminal group. Conclusions: There is no defic
iency of complement in children treated with CAPD. High levels of C3d
and D can be explained by the reduction of their elimination by the ki
dney. The increased levels of the other factors are presumably due to
increased synthesis in renal failure. This does not seem to be caused
by CAPD.