Development of means to augment peritoneal urea clearances: the synergistic effects of combining high dialysate temperature and high dialysate flow rates with dextrose and nitroprusside.

By combining: a) nitroprusside (4.5 mg/L); b) dextrose concentration of 42.5 gm/L; c) dialysate temperature of 42 degrees C and d) dialysate flow rates of 3.5 L/hour in seven uremic subjects on CAPD, it was possible to increase peritoneal urea clearance up to 35.6 +/- 3.8 ml/min/1.73 m2 (range 30.3 to 42.2). This effect in six out of seven cases was associated with a fall in blood pressure and an increase in heart rate. This study is the first which deals with a combination of these factors and demonstrates that this approach is easy to handle, does not require the use of mechanical devices, and is available at any bedside.