CAPD in diabetics: use of aminoacids.

Advantages of CAPD in diabetic uremic patients may offer better control of visual and neurological disease. There remain some undesired side effects, i.e: obesity, blood lipid imbalance and loss of appetite due to glucose absorption. In February 1988 four diabetic uremic CAPD patients (2 males and 2 females with an average age of 62.25 +/- 11.32, range 52-76) began treatment substituting one of the usual glucose exchanges with 1% aminoacid solution. Treatment time averaged 52 months (range 9-17). Each month the patients were examined clinically and via blood chemistries. Every 3 months clearances, residual renal function, ocular fundus and motor nerve conductance velocity were measured. Plasma nitrogen increased, while triglycerides, cholesterol and total protein remained unchanged; bicarbonate decreased causing slight acidosis. There were no significant variations of either clearances or ultrafiltration and the quantity of insulin administered decreased. Results confirm that a 1% aminoacid solution can be used as an osmotic agent in peritoneal dialysis to prevent some of the complications such as blood lipid imbalance. The slight acidosis can be corrected by increasing the buffer content of the bag.