Modifications of endocrine-metabolic abnormalities of uremia by continuous ambulatory peritoneal dialysis.

The endocrine-metabolic disturbances of renal failure have numerous underlying mechanisms. These include abnormal secretion, transport and target cell binding and impaired synthesis or elimination by the diseased kidney. Neither hemodialysis nor CAPD removes large quantities of retained hormones. By correcting certain metabolic, fluid and electrolyte abnormalities, however, dialysis may improve some endocrine disturbances. Other factors such as malnutrition, glucose loading, protein loss, trace metal accumulation and drug ingestion may influence the endocrine-metabolic aspects of renal failure treated by dialysis. Hormonal stimulation and action can be adversely affected by hyperendorphinism due to retained opioids which may be removed by dialysis [88]. Possibly due to the more permeable membrane or because of continuous therapy, peritoneal dialysis seems to have a more salutary effect on hormonal regulation of salt and water balance, of erythrocyte mass and of female reproductive function than hemodialysis does.