title: Natural changes in peritoneal equilibration test results in continuous ambulatory peritoneal dialysis patients: a retrospective, seven year cohort survey.
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.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, R.O.C.
authors.forename: K Y
authors.initials: KY
authors.lastname: Hung
authors.forename: J W
authors.initials: JW
authors.lastname: Huang
authors.forename: T J
authors.initials: TJ
authors.lastname: Tsai
authors.forename: W Y
authors.initials: WY
authors.lastname: Chen
mesh_terms: D000328:Adult; D000367:Age Factors; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003404:Creatinine / Q000032:analysis / Q000097:blood; D048909:Diabetes Complications; D015314:Dialysis Solutions / Q000032:analysis; D005260:Female; D005947:Glucose / Q000032:analysis; D006801:Humans; D007674:Kidney Diseases / Q000150:complications; D007678:Kidney Glomerulus / Q000473:pathology; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D010531:Peritoneal Dialysis, Continuous Ambulatory; D010537:Peritoneum / Q000378:metabolism*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014462:Ultrafiltration
chemical_list: D015314:Dialysis Solutions; D003404:Creatinine; D005947:Glucose