Abstract
Long term complications of continuous ambulatory peritoneal dialysis have not been identified clearly. Membrane failure, i.e. inability to control body weight despite continuous use of hypertonic solutions, has been described extensively in France but has received little attention in North America. In Toronto, 14 of 508 patients failed CAPD because of membrane failure. The pathogenesis of this complication is not well understood but it is due, in part, to rapid decrease in the osmolality of the dialysate because of rapid absorption of glucose. Further investigations are urgently needed to explain the pathogenesis and prevention of this complication.

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