Abstract
CAPD patients appear to have higher levels of plasma renin activity than hemodialysis patients. Increased angiotensin n may result in increased secretion of 18-OH-B and aldosterone by the adrenal zona glomerulosa.
Differences in treatment design between continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD) may affect secretion of adrenocorticosteroids. Ultrafiltration during CAPD is continuous and gradual. Therefore, CAPD patients experience only minor fluctuations in extracellular fluid volume and are usually at or near their estimated dry weight (EDW). In contrast, ultrafiltration in HD patients is rapid but intermittent. Hemodialysis patients approach their EDW only at the end of each treatment period. Hemodialysis patients, therefore, may remain significantly above their EDW for prolonged periods. CAPD allows patients to liberalize their dietary intake of potassium. Some CAPD patients may require potassium supplementation (I). In contrast, HD patients may need to restrict their dietary intake of potassium to prevent potentially lethal hyperkalemia. Heparin is routinely administered during HD but not during CAPD. The present study was designed to determine if these differences in treatment design produce greater stimulation of the adrenal zona glomerulosa in CAPD than in HD patients.
Get full access to this article
View all access options for this article.