Biochemical studies on patients undergoing continuous ambulatory peritoneal dialysis.

Biochemical studies are being performed in chronically renal insufficient patients undergoing treatment by CAPD. Serum protein and albumin levels have remained stable during treatment as have the ratios of essential/non-essential amino acids and valine/glycine in plasma. Dietary intake therefore appears to adequately compensate dialysate losses. Serum calcium and phosphate as well as immunoreactive parathyroid hormone concentration and alkaline phosphatase levels did not change during the treatment. The glucose load due to the high concentrations of glucose in the dialysate may have adverse effects on the glucose tolerance and insulin secretion of CAPD patients. However, in fasting patients it could be shown that only the 4.25% glucose dialysate causes any increase in plasma glucose levels with a concommitant rise of insulin secretion, an exchange with a 1.5% glucose dialysate having relatively little effect on these parameters. Quantification of the individual serum lipoproteins is also being performed during CAPD. No changes were observed in alpha-cholesterol levels, but 50% of the patients have shown significant increases in total serum cholesterol, beta-cholesterol and serum triglycerides in the course of treatment. In these cases dietary consequences must be considered in order to minimise the potential artherosclerotic risk.