PERITONEAL DEFENSE IN CONTINUOUS AMBULATORY VERSUS CONTINUOUS CYCLIC PERITONEAL-DIALYSIS

被引：43

作者：

DEFIJTER, CWH ^{[1
]}

VERBRUGH, HA ^{[1
]}

OE, LP ^{[1
]}

PETERS, EDJ ^{[1
]}

VANDERMEULEN, J ^{[1
]}

DONKER, AJM ^{[1
]}

VERHOEF, J ^{[1
]}

机构：

[1] UNIV UTRECHT,DEPT MICROBIOL,UTRECHT,NETHERLANDS

来源：

KIDNEY INTERNATIONAL | 1992年 / 42卷 / 04期

关键词：

D O I：

10.1038/ki.1992.371

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Several centers have reported a lower rate of peritonitis among adult patients on continuous cyclic peritoneal dialysis (CCPD) as compared to those undergoing continuous ambulatory peritoneal dialysis (CAPD). Preliminary results of our ongoing prospective randomized study comparing CAPD-Y with CCPD also suggest a lower peritonitis incidence among CCPD-treated patients. To investigate whether the two dialysis regimens could result in differences in local host defense, we studied peritoneal macrophage (PMO) function and effluent opsonic activity in eight patients established on CAPD-Y matched with eight chronic CCPD patients. Since short and long dwell times are inherent to both dialysis modalities, and we previously found that dwell time has an impact on PMO function and effluent opsonic activity, patients were studied after both a short (4 hr) and a long (15 hr) dwell time. In both patient groups PMO phagocytic capacity increased significantly with dwell time (39 +/- 3.3% at 4 hr vs. 58 +/- 4.2% at 15 hr in CAPD patients, and 40 +/- 3.9 vs. 72 +/-3.3% in CCPD patients; P < 0.01), as did PMO peak chemiluminescence response (31 +/- 4.9 vs. 77 +/- 7.2 counts . min-1/10(4) cells in CAPD, and 22 +/- 3.9 vs. 109 +/- 21.2 counts . min-1/10(4) cells in CCPD; P < 0.01) and effluent opsonic activity (41 +/- 7.6 vs. 73 +/- 5.8% in CAPD and 39 +/- 6.2 vs. 70 +/- 5.9% in CCPD: P < 0.01). However, no significant difference was found in either variable between CAPD and CCPD patients when dwell times were equal. In conclusion, no differences were observed in PMO function or effluent opsonic activity between matched CAPD-Y and CCPD patients when dwell times were equal. In both patient groups prolongation of dwell time enhanced PMO function as well as effluent opsonic activity, thereby providing a better host defense. The improvement in peritoneal defenses may, in part, be responsible for the lower peritonitis incidence observed among CCPD-treated patients.

引用

页码：947 / 950

页数：4

共 23 条

[1]

Alobaidi H M, 1986, Nephrol Dial Transplant, V1, P16

[2]

DEFIJTER CWH, 1990, KIDNEY INT, V37, P327

[3]

DIAZBUXO JA, 1989, PERITON DIALYSIS INT, V9, P9

[4]

DIAZBUXO JA, 1985, KIDNEY INT, V27, P179