Transport of water and solutes in uremic patients with chronic hepatic disease in CAPD.
Ten patients with chronic hepatic disease (CHD) were compared with 34 non-CHD (N) pts. All patients underwent a peritoneal equilibration test; the asymptotic curves for small solutes transport were transformed into straight lines; protein transport was also expressed as a straight line; the slopes of these linear functions were used as index of solute transfer. CHD patients showed increased UF and transport of all solutes. The well-known relationships between UF and glucose absorption and between UF and dialysate sodium concentration were observed in N, but not in CHD patients. In patients without hepatic disease there was also a relationship between UF and the glucose transport slope, which was not observed in CHD pts. These results are probably due to the influence of hepatic lymph production plus increased lymphatic removal, observed in non uremic patients affected by cirrhosis, on the mechanisms of water and solute transport in CAPD. CHD patients can be managed either with CAPD or with short frequent exchanges. Ascites production can be evaluated by the difference between the observed UF in a patient with CHD and the expected UF in N patients.