Biochemical parameters, nutritional status and efficiency of dialysis in CAPD and CCPD patients

Several studies indicate that small solute transport is influenced by perit oneal dialysate volume and dwell time. This study focuses on the clinical i mpact of peritoneal dialysis modality, continuous ambulatory peritoneal dia lysis (CAPD) and continuous cycling peritoneal dialysis (CCPD). Methods: We studied 18 pa tients on CAPD and 11 on CCPD for 18 months and assessed bio chemical parameters, nutritional status and efficiency of dialysis at 6-mon th intervals. Results: Four-hour D/P urea and creatinine ratios were simila r in both CAPD and CCPD patients. However, 24-hour D/P urea and creatinine ratios were significantly higher in CAPD than in CCPD patients (0.9 +/- 0.1 vs. 0.8 +/- 0.2 and 0.8 +/- 0.1 vs. 0.6 +/- 0.2, p < 0.05 and p < 0.01, re spectively). The dialysate urea nitrogen concentration was significantly di fferent between the two groups (65 +/- 14 mg/dl in CAPD, 48 +/-: 13 mg/dl i n CCPD; p < 0.05). Total weekly Kt/V and total weekly creatinine clearance were not significantly different between CAPD and CCPD patients at 18 month s (1.6 +/- 0.4 vs. 1.7 +/- 0.3 and 52 +/- 21 vs. 50 +/- 12 liters, respecti vely). Two-way ANOVA with a post-hoc Bonferroni-Dunn test showed serum pota ssium concentration was significantly lower in CCPD patients at 18 months ( 3.8 +/- 0.5 mEq/l, p < 0.05), and significant increases in triglyceride lev els in the CAPD groups by 18 months (301 +/- 286 mg/dl, p < 0.05). Conclusi on: This study demonstrates that the mean serum triglyceride level increase s in CAPD patients overtime, and the mean serum potassium concentration dec reases in CCPD patients at 18 months. Dialysis adequacy and nutritional sta tus are not significantly different between the two peritoneal dialysis mod alities, CAPD and CCPD. We suggest the peritoneal dialysis prescription for CAPD or CCPD with respect to volume and frequency of exchanges be individu alized to achieve adequate of therapy.