Metabolic parameters of CAPD and CCPD in diabetics with terminal renal insufficiency

The effects of continuous ambulant (CAPD) and continuous cyclic peritoneal dialysis (CCPD) on a series of laboratory parameters in the blood and dialysate were assessed in two groups of nine juvenile diabetics each, suffering from terminal renal failure. The CCPD patients showed higher urea and creatinine levels in serum and, as a result of lower protein loss via the dialysate, also higher total protein and transferrin concentrations than the CAPD patients. The glucose absorption of the CCPD patients was about 50% lower than of the CAPD patients. Control of diabetes was equally successful with both procedures, the HbA1 values were less than 10%. The triglycerides were lowered by both CAPD and CCPD on the condition that the absorbed glucose amounts were included in the calculation of the dietary adjustment. Cholesterol and HDL-cholesterol remained unchanged. Thus CCPD appears to have advantages over CAPD, especially with respect to the lowering of the glucose absorption and the protein loss. The wider application of both methods will be, however, less influenced by the metabolic parameters than by other factors such as reduction of the risk of peritonitis.