Longitudinal evaluation of transport kinetics in children receiving peritoneal dialysis.
Functional stability of the peritoneal membrane is necessary for maintenance of peritoneal dialysis (PD) as a therapeutic option. Few studies have investigated this issue in children. We evaluated the peritoneal membrane solute transport capacity longitudinally in 26 children (mean age 11.0+/-5.5 years) receiving long-term PD. Each patient underwent a standardized peritoneal equilibration test on two occasions (mean interval between studies 19.8+/-5.9 months) to determine solute dialysate to plasma (D/P) ratios, dialysate glucose to initial dialysate glucose (D/D(0)) ratios, and mass transfer area coefficients (MTAC). The correlation of transport capacity with peritonitis history was also assessed. No significant change in MTAC, D/P, or D/D(0) values were found when comparing original and follow-up data of the group overall. However, transport of creatinine and glucose was significantly (P<0.05) greater in the peritonitis group compared with the group without peritonitis, and differences in the change over time between the peritonitis groups was significant for MTAC creatinine (P=0.035) and D/D(0) glucose (P=0.020). In summary, this experience demonstrates functional stability of the peritoneal membrane in pediatric patients receiving PD. However, follow-up assessments of peritoneal solute kinetics may be necessary in patients with a history of peritonitis in order to permit early identification of those who may be at risk for ultrafiltration failure and sclerosing peritonitis.
Warady
B A
BA
The Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA, bwarady@cmh.edu
Fivush
B
B
Andreoli
S P
SP
Kohaut
E
E
Salusky
I
I
Schlichting
L
L
Pu
K
K
Watkins
S
S
D000293:Adolescent; D001692:Biological Transport; D001786:Blood Glucose / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000032:analysis / Q000097:blood; D015314:Dialysis Solutions / Q000737:chemistry; D005947:Glucose / Q000032:analysis; D006801:Humans; D007700:Kinetics; D008137:Longitudinal Studies; D008566:Membranes / Q000378:metabolism; D010530:Peritoneal Dialysis; D010537:Peritoneum / Q000378:metabolism*; D010538:Peritonitis / Q000378:metabolism; D014508:Urea / Q000032:analysis / Q000097:blood
D001786:Blood Glucose; D015314:Dialysis Solutions; D014508:Urea; D003404:Creatinine; D005947:Glucose