Influence of continuous ambulatory peritoneal dialysis on serum alpha 1-acid glycoprotein concentration and drug binding.

The influence of continuous ambulatory peritoneal dialysis (CAPD) on the concentrations of alpha 1-acid glycoprotein in serum and dialysate and on the serum binding of oxprenolol, propranolol and phenytoin has been studied. Before starting CAPD treatment, the serum binding of oxprenolol and propranolol was higher and that of phenytoin lower than in healthy volunteers, and the serum alpha 1-AGP concentration was higher. During the first days to weeks after starting CAPD, the serum alpha 1-AGP concentration rose with a concomitant increase in the binding of oxprenolol and propranolol. Subsequently, the alpha 1-AGP level and the binding of oxprenolol and propranolol decreased to the values found before starting CAPD. The binding of phenytoin showed little change. The concentration of alpha 1-AGP in dialysate was 2 to 5% of that in serum.