No significant differences in peritoneal fluid handling in children using PH-neutral or acidic solutions.
OBJECTIVE
Differences in peritoneal fluid handling in the acute setting can be expected if children are converted to pH-neutral dialysis solutions because conventional acidic solutions exert toxic effects on peritoneal mesothelial cells and microcirculation. Peritoneal fluid kinetics was therefore investigated with both types of solutions in a group of children.


METHODS
Peritoneal equilibration tests (PETs) were performed in 12 patients [mean age 70 months, mean time on peritoneal dialysis (PD) 18 months] using a pH-neutral PD fluid (Physioneal 3.86%; Baxter Ltd, Castlebar, Ireland) and dextran 70 as a volume marker. The results of these PETs were compared to those of a historic group of 12 children (mean age 75 months, mean time on PD 17 months).


METHODS
Pediatric dialysis unit in a tertiary institute.


METHODS
Stable pediatric PD patients.


METHODS
Transcapillary ultrafiltration (TCUF) and marker clearance, dialysate-to-plasma (D/P) ratios for urea and creatinine, and D(t)/D(0) ratio for glucose.


RESULTS
TCUF and lymphatic absorption were not different between the two groups. There was also no significant difference in small solute clearance measured by D/P ratio for urea and creatinine and D(t)/D(0) ratio for glucose.


CONCLUSIONS
Peritoneal fluid kinetics is not significantly altered if pH-neutral dialysis solutions are applied compared to acidic solutions. An altered TCUF, as is hypothetically possible using an acidic solution, was not established.
Nourse
Peter
P
Department of Pediatric Nephrology, University Medical Center, Utrecht, The Netherlands. nourse@sun.ac.za
van de Kar
Nicole C A J
NC
Willems
Hans L
HL
Schröder
Cornelis H
CH
D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000378:metabolism; D015314:Dialysis Solutions / Q000493:pharmacokinetics*; D005500:Follow-Up Studies; D005947:Glucose / Q000378:metabolism; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000628:therapy*; D010530:Peritoneal Dialysis / Q000379:methods*; D010537:Peritoneum / Q000378:metabolism*; D014508:Urea / Q000378:metabolism
D015314:Dialysis Solutions; D014508:Urea; D003404:Creatinine; D005947:Glucose