Personal dialysis capacity (PDC(TM)) test: a multicentre clinical study.
BACKGROUND
The assessment of the peritoneal membrane capacity and physiology of the individual patient is becoming increasingly important. It allows the prescription of an individualized peritoneal dialysis (PD)-regimen, and the monitoring of peritoneal membrane function over time. The PDC(TM) program offers the possibility to evaluate the peritoneal membrane characteristics and to predict solute and water removal by simulation of different treatment regimens.


METHODS
This study evaluates the relevance of the PDC(TM) program when routinely used. The PDC(TM) data of 336 patients from nine different centres in Europe were evaluated.


RESULTS
The area parameter was 20 985+/-7578 cm/1.73 m(2) (mean+/-SD). The reabsorption of fluid after dissipation of glucose, Jv(AR), was 1.97+/-1.00 ml/min/1.73 m(2). The large pore fluid flux, Jv(L), was 0.11+/-0.07 ml/min/1.73 m(2). A multivariate model for prediction of serum albumin included dialysate protein loss, Jv(L), Jv(AR), nPCR, A(0)/deltaX, BMI and gender (R(2)=0.81, P<0.001). Total clearance fell with increasing PD duration (P<0.001). A negative relation between A(0)/deltaX and ultrafiltration (rho=-0.26, P<0.05), a positive relation between A(0)/deltaX and peritoneal creatinine clearance (rho=0.52, P<0.05) and urea clearance (rho=0.36, P<0.05), and a positive relation between measured peritoneal creatinine and urea clearance (rho=0.64, P<0.01) was observed.


CONCLUSIONS
In summary, the present study shows that the PDC(TM) program is a robust, accurate method to describe the peritoneal membrane transport characteristics. Analysis of PDC(TM) data of large groups of patients, especially if followed up over time, can give interesting information on the physiology of the peritoneal membrane and the impact of different parameters on it.
Van Biesen
Wim
W
Department of Internal Medicine, University Hospital Gent, Belgium. wim.vanbiesen@rug.ac.be
Carlsson
Ola
O
Bergia
Roberto
R
Brauner
Michael
M
Christensson
Anders
A
Genestier
Sandrine
S
Haag-Weber
Marianne
M
Heaf
James
J
Joffe
Preben
P
Johansson
Ann-Cathrine
AC
Morel
Bertrand
B
Prischl
Friedrich
F
Verbeelen
Dirk
D
Vychytil
Andreas
A
D000368:Aged; D001692:Biological Transport; D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D015314:Dialysis Solutions / Q000737:chemistry / Q000493:pharmacokinetics*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000628:therapy*; D007677:Kidney Function Tests; D016014:Linear Models; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D015999:Multivariate Analysis; D010347:Patient Care Planning; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D010537:Peritoneum / Q000378:metabolism; D010539:Permeability; D011237:Predictive Value of Tests; D011336:Probability; D018570:Risk Assessment; D016896:Treatment Outcome
D015314:Dialysis Solutions; D008567:Membranes, Artificial; D003404:Creatinine