Clinical evaluation of the peritoneal equilibration test: a population-based study.
A total of 143 Peritoneal Equilibration Tests (PETs) were performed in 104 CAPD patients over a period of 18 months. A normal range (95% confidence limits) was constructed from 100 tests (68 consecutive new patients, 32 routine tests on problem-free patients) using a 2-dimensional plot of solute transfer (D/Pcreat) and ultrafiltration volume. These two parameters correlated inversely (r = -0.59, P < 0.0001) allowing calculation of a regression line. In the short term (< 3 months) D/Pcreat was stable across a wide range of values (0.45-0.98) with good correlation between tests indicating reproducibility (r = 0.94, P < 0.001). Repeated tests beyond 3 months were variable, explaining changes in the clinical picture, and in the majority of cases shifts in D/Pcreat and ultrafiltration parallelled the regression line for the whole population. Six of seven (85%) of patients with mechanical problems and 14 of 15 (93%) with poor ultrafiltration had at least one abnormal test, and these two problems could be distinguished in 90% of cases by 2-dimensional plotting. In five with ultrafiltration failure, dialysate volumes were less than predicted by solute clearance, and these patients failed continuous cycling peritoneal dialysis (CCPD). In contrast, a good response to CCPD was predicted correctly in five patients with high solute clearance. In nine patients with plasma creatinine > 1250 mumol/l the PET was normal. The PET is a useful adjunct to understanding and prescribing peritoneal dialysis, particularly when repeated tests are compared to a well-defined normal population.
Renal Unit, North Staffordshire Royal Infirmary, Stoke-on-Trent, UK.
S J
SJ
Davies
B
B
Brown
J
J
Bryan
G I
GI
Russell
D000293:Adolescent; D000328:Adult; D000368:Aged; D003404:Creatinine / Q000097:blood / Q000378:metabolism; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects; D010537:Peritoneum / Q000503:physiopathology*; D012016:Reference Values
D003404:Creatinine; D005947:Glucose