Journal Article

Sequential peritoneal equilibration test: a new method for assessment and modelling of peritoneal transport

Magda Galach, Stefan Antosiewicz, Daniel Baczynski, Zofia Wankowicz and Jacek Waniewski

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 28, issue 2, pages 447-454
Published in print February 2013 | ISSN: 0931-0509
Published online February 2013 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfs592
Sequential peritoneal equilibration test: a new method for assessment and modelling of peritoneal transport

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Background

In spite of many peritoneal tests proposed, there is still a need for a simple and reliable new approach for deriving detailed information about peritoneal membrane characteristics, especially those related to fluid transport.

Methods

The sequential peritoneal equilibration test (sPET) that includes PET (glucose 2.27%, 4 h) followed by miniPET (glucose 3.86%, 1 h) was performed in 27 stable continuous ambulatory peritoneal dialysis patients. Ultrafiltration volumes, glucose absorption, ratio of concentration in dialysis fluid to concentration in plasma (D/P), sodium dip (Dip D/P Sodium), free water fraction (FWF60) and the ultrafiltration passing through small pores at 60 min (UFSP60), were calculated using clinical data. Peritoneal transport parameters were estimated using the three-pore model (3p model) and clinical data. Osmotic conductance for glucose was calculated from the parameters of the model.

Results

D/P creatinine correlated with diffusive mass transport parameters for all considered solutes, but not with fluid transport characteristics. Hydraulic permeability (LpS) correlated with net ultrafiltration from miniPET, UFSP60, FWF60 and sodium dip. The fraction of ultrasmall pores correlated with FWF60 and sodium dip.

Conclusions

The sequential PET described and interpreted mechanisms of ultrafiltration and solute transport. Fluid transport parameters from the 3p model were independent of the PET D/P creatinine, but correlated with fluid transport characteristics from PET and miniPET.

Keywords: peritoneal equilibration test; peritoneal transport assessment; peritoneal transport modelling; three-pore model; water transport

Journal Article.  4850 words.  Illustrated.

Subjects: Nephrology

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