title: Peritoneal dialysis clearances. A practical approach to the measurement of small- and middle-molecule clearances.
abstract: This study was designed to (1) develop a simple technique of estimating 'middle-molecule' clearances in peritoneal dialysis patients using vitamin B12 as a marker; (2) evaluate changes in small- and middle-molecule clearances during a single 24- or 36-hour peritoneal dialysis, and (3) determine if using 4.25% rather than 1.5% dextrose exchanges alters the clearances of small and middle molecules. Measurement of clearance following the intramuscular injection of vitamin B12 was found to be a reliable method of estimating the clearance of middle molecules. Small- and middle-molecule clearances remain constant throughout an individual 24- or 36-hour dialysis. In addition, small-molecule clearances increase significantly with 4.25% dextrose dialysate but return to prior values when 1.5% dextrose dialysate is reinstituted.
mesh_terms: D006801:Humans; D007273:Injections, Intramuscular; D007668:Kidney / Q000378:metabolism*; D007676:Kidney Failure, Chronic / Q000628:therapy; D008657:Metabolic Clearance Rate; D010530:Peritoneal Dialysis; D014118:Toxins, Biological / Q000097:blood*; D014511:Uremia / Q000097:blood; D014805:Vitamin B 12 / Q000008:administration & dosage / Q000378:metabolism
chemical_list: D014118:Toxins, Biological; D014805:Vitamin B 12