Peritoneal elimination of homocysteine moieties in continuous ambulatory peritoneal dialysis patients

Background The amount of total homocysteine eliminated by peritoneal dialys is and its relationship to peritoneal transport characteristics in continuo us ambulatory peritoneal dialysis (CAPD) patients are unknown. Methods. The influence of total homocysteine, folate, and vitamin B-12 plas ma concentrations, serum albumin levels, age, sex, dialysate to plasma rati o (D/P) creatinine, D/D-0 glucose, DTP albumin, dialysate effluent volume, and effluent albumin on the daily peritoneal excretion of total homocystein e was investigated in 39 CAPD patients. The relationship of DIP creatinine to D/P total homocysteine, DTP free homocysteine, and D/P protein-bound hom ocysteine was analyzed additionally in a subgroup of 25 patients. Results. We observed a significant influence of plasma total homocysteine c oncentrations (P = 0.0001) of the daily dialysate effluent volume (P = 0.02 21) and of the D/P creatinine (P = 0.0132) on peritoneal elimination of tot al homocysteine. The daily peritoneal excretion of total homocysteine was 3 8.94 +/- 20.82 mu mol (5.27 +/- 2.81 mg). There was a positive linear assoc iation of the daily total homocysteine elimination with plasma total homocy steine concentrations (P = 0.0001). A significant linear correlation was ob served between D/P creatinine and DIP total homocysteine (P = 0.0001). D/P free homocysteine (P = 0.0001), as well, as D/P protein-bound homocysteine (P = 0.0001). Conclusions. The peritoneal elimination of total homocysteine primarily dep ends on the plasma total homocysteine concentration. Elevated total homocys teine plasma levels cannot be reduced efficiently by peritoneal dialysis.