Natural changes in peritoneal equilibration test results in continuous ambulatory peritoneal dialysis patients: a retrospective, seven year cohort survey

Artif Organs. 2000 Apr;24(4):261-4. doi: 10.1046/j.1525-1594.2000.06478.x.

Abstract

We conducted a retrospective, 7 year cohort survey to examine the natural changes in peritoneal equilibration test (PET) results in patients with long-term uneventful continuous ambulatory peritoneal dialysis (CAPD). Thirty-two (17 males, 15 females) patients on CAPD with two or more standard PETs performed more than 6 months apart, in the absence of peritoneal insult, were included. Changes and pattern of PET results were evaluated by the dialysate to plasma ratio of creatinine (D:P-cre), the fourth h dialysate to instilled glucose ratio (D4:Do) and ultrafiltration volume (UF, ml). The subgroups included high (H), high-average (HA), low-average (LA), or low (L) transporters with the dividing ratios (D:P-cre) of >0.81, >0. 65 to 0.81, >0.5 to 0.65, and <0.5, respectively. The median D:P-cre significantly decreased (p = 0.04), but neither the D4:Do nor the final median UF significantly decreased. The change in D:P-cre was strongly and inversely correlated with the initial D:P-cre value (r = -0.68; p < 0.05). A similar relationship was found between the change in the final D4:Do and the initial D4:Do (r = -0.752; p < 0. 01) and between the change in the final UF and the initial UF (r = -0.875; p < 0.01). No correlation was found between the change in D:P-cre and the age of the patient, the time interval between PETs, monthly dialysate glucose exposure, or underlying diabetes/non-diabetes. The final peritoneal transport pattern was altered with 5 (15.6%) patients remaining in the extreme subgroups (H or L) and, by contrast, 84.4% (27/32) of the patients now in the averaged (HA or LA) groups (p < 0.01, chi2 test). We demonstrated a natural "centralization" migration of PET results after long-term uneventful CAPD, which may help to explain why patients with extreme PET characteristics, that is, H or L, continued to do well on CAPD.

MeSH terms

  • Adult
  • Age Factors
  • Chi-Square Distribution
  • Cohort Studies
  • Creatinine / analysis
  • Creatinine / blood
  • Diabetes Complications
  • Dialysis Solutions / analysis
  • Female
  • Glucose / analysis
  • Humans
  • Kidney Diseases / complications
  • Kidney Glomerulus / pathology
  • Linear Models
  • Longitudinal Studies
  • Male
  • Peritoneal Dialysis, Continuous Ambulatory*
  • Peritoneum / metabolism*
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Ultrafiltration

Substances

  • Dialysis Solutions
  • Creatinine
  • Glucose