The association between peritoneal charge barrier dysfunction and protein lost during continuous ambulatory peritoneal dialysis.

BACKGROUND/AIMS The main purpose of the present study was to determine the effect of peritoneal charge barrier dysfunction on hypoalbuminemia during CAPD. METHODS We measured the association of dialysis dose, peritoneal equilibration test (PET) results (ratio of dialysate and plasma creatinine), and peritoneal charge barrier index (ratio of pancreatic and salivary α-amylase clearance) on protein loss in 33 patients on maintenance CAPD. All patients were from a single institution and were diagnosed with chronic nephritis (n = 18 cases), diabetic nephropathy (n = 8), hypertension (n = 5), and hepatitis B virus-associated glomerulonephritis (n = 2). RESULTS The mean (± SD) dialysate protein loss was 4.04 g (± 1.97) per day. Protein loss was positively correlated with dialysis dose (r = 0.438, p = 0.01) but was not significantly correlated with PET results. The mean (± SD) peritoneal charge barrier index was 6.12 (± 21.20) and was inversely correlated with protein loss into the peritoneal dialysate (r = -0.532, p < 0.01). CONCLUSIONS Taken together, our study of CAPD patients indicates that protein loss into the peritoneal dialysate increases with peritoneal dialysis dose and with disruption of the peritoneal charge barrier. © 2013 S. Karger AG, Basel.