Reproductive Function in Dialysis Patients: CAPD vs Hemodialysis

Abstract

A variety of hormonal disturbances and reproductive abnormalities occur in women on chronic maintenance hemodialysis. Recently, it has been noted that, when transferred from hemodialysis to continuous ambulatory peritoneal dialysis (CAPD), some women have resumed normal menses with ovulatory cycles. We compared menstrual histories, vaginal hormonal smears and ovulatory curves in 12 women on hemodialysis vs. seven women on CAPD under the age of 45. Eightysix per cent of the CAPD patients and 25% of the hemodialysis patients had regular menses. Upon transfer to CAPD, two amenorrheic females resumed regular menses within 21 months. Only two patients (one in each group) had ovulatory cycles. All patients had a vaginal estrogen effect. The return of regular menses in CAPD patients may be due to improved middle-molecule clearances with secondary normalization of the hormonal imbalances.