Effect of diabetes and peritonitis on the peritoneal equilibration test.
Peritoneal equilibration tests (PET) were performed on 47 patients (15 diabetics) who had been on CAPD for 1 to 112 months. Among new patients on CAPD (1 to 3 months) with no history of peritonitis, diabetics had higher D/PCr than non-diabetics (P < 0.02). However, after > or = 7 months of CAPD, in patients with < or = 2 episodes of peritonitis, glucose and creatinine transport rates were lower (P < 0.05) in diabetic than non-diabetic patients. Among patients on CAPD for > or = 7 months, creatinine (P < 0.05) and glucose transport (P < 0.01) were higher in patients with a history of > or = 3 episodes of peritonitis than in those with < or = 2 episodes. Drain volumes did not differ between any of the subgroups (all P > 0.05). The observations in patients newly established on CAPD were substantiated in a larger study of 55 non-diabetic and 35 non-insulin dependent diabetic patients. D/D0 glucose correlated with plasma glucose (r = 0.40, P < 0.02) in the diabetic group. Net ultrafiltration was reduced in hyperglycemic (P = 0.022) but not normoglycemic diabetics (non-diabetics 231 +/- 167 ml, hyperglycemic diabetics 127 +/- 177 ml, normoglycemic diabetics 238 +/- 159 ml). Creatinine clearance was higher in normoglycemic (P = 0.02) but not hyperglycemic diabetics (non-diabetics 6.8 +/- 0.9 ml/min, hyperglycemic diabetics 6.9 +/- 0.8 ml/min, normoglycemic diabetics 7.4 +/- 0.7 ml/min). These data show that diabetes and peritonitis incidence should be borne in mind when interpreting results of the PET.(ABSTRACT TRUNCATED AT 250 WORDS)