Mechanisms for Inefficient Peritoneal Dialysis in Acute Renal Failure Associated with Heat Stress and Exercise

SUMMARY

The inefficiency of peritoneal dialysis in reducing the serum urea nitrogen concentration in heat stress and exercise-induced acute renal failure is due to an increased rate of urea production rather than to diminished clearances of urea. Although peritoneal urea clearances of urea were normal, a selective reduction in the clearances of larger solutes—namely, urate and creatinine—was a consistent finding. The combination of inferred hypercatabolism and a defect in peritoneal permeability may limit the effectiveness of peritoneal dialysis in the treatment of this form of acute renal failure. These patients with renal failure associated with heat stress and exercise are similar to traumatic cases and may need frequent hemodialysis as an effective means of treatment.