Peritoneal transport in peritoneal dialysis patients is not affected by transitorily successful renal transplantation.
Patients returning to peritoneal dialysis (PD) from failed renal transplantation are recognized to be inflamed, and this situation might produce a high peritoneal solute transport status. We wanted to determine if a period of time with a kidney allograft induces a change in peritoneal function. We studied 19 PD patients who had been living with a graft for a mean of 47 +/- 39 months. We studied their peritoneal function upon starting PD (baseline), immediately before transplantation (pre-Tx), and after returning to PD when the graft failed (post-Tx). We analyzed the peritoneal mass transfer coefficients for urea (U-MTAC) and creatinine (Cr-MTAC), the dialysate-to-plasma ratio of creatinine (D/P-Cr), and net ultrafiltration (UF). We observed no significant differences in the various variables pre-Tx and post-Tx. The U-MTAC post-Tx was significantly lower than at PD baseline (25.9 +/- 8 mL/min vs. 20.2 +/- 5 mL/min, p = 0.03). The U-MTAC and Cr-MTAC post-Tx were not correlated with months on a graft or with MTAC values at baseline. In inherent high transporters (Cr-MTAC > or = 11.5 mL/min at baseline, n = 8), we observed a significant reduction in Cr-MTAC post-Tx (15.2 +/- 2 mL/min vs. 10.2 +/- 4 mL/min, p = 0.03). Three of these patients remained high transporters post-Tx. We conclude that peritoneal function upon reinitiating PD after transplantation is similar to function in the pre-transplantation phase; and that a high peritoneal transport status is more prevalent at first initiation onto PD than at return after transplantation, suggesting that inherently high transport is almost exclusively a feature of an intact, predialysis peritoneum.
Fernández
Ernesto J
EJ
Servicio de Nefrología, Hospital Universitario La Paz, Madrid, Spain.
del Peso
Gloria
G
Bajo
Auxiliadora
A
Jiménez
Carlos
C
de Gracia
Raquel
R
Ros
Silvia
S
Selgas
Rafael
R
D000328:Adult; D001692:Biological Transport; D003404:Creatinine / Q000378:metabolism; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D010530:Peritoneal Dialysis; D010537:Peritoneum / Q000378:metabolism*; D014508:Urea / Q000378:metabolism
D014508:Urea; D003404:Creatinine