Does the biocompatibility of the peritoneal dialysis solution matter in assessment of peritoneal function?
BACKGROUND
Peritoneal function tests are performed in peritoneal dialysis (PD) patients to characterize peritoneal membrane status. A low pH/high glucose degradation product (GDP) dialysis solution is used as the test solution. The objective of the present study was to compare a 3.86% glucose, low pH/high GDP dialysis solution (pH 5.5) with a 3.86% glucose, normal pH/low GDP dialysis solution (pH 7.4) in assessments of peritoneal membrane function.


METHODS
Two standard peritoneal permeability analyses (SPA) were performed in 10 stable PD patients within 2 weeks. One SPA was done with the 3.86% low pH/high GDP solution, and the other with the 3.86% normal pH/low GDP solution. The sequence of the two tests was randomized.


RESULTS
Fluid transport parameters and glucose absorption were not different between the two groups. No differences were found for the mass transfer area coefficients (MTACs) of low molecular weight solutes calculated over the whole dwell. However, MTAC urea in the first hour of the dwell was higher in the test done with low pH/high GDP dialysate, suggesting more peritoneal vasodilation. No difference was found in protein clearances. Sodium sieving at multiple time points during the dwell was similar with the two solutions.


CONCLUSIONS
The results obtained with the glucose-containing normal pH/low GDP dialysis solution were similar to those obtained with the glucose-containing low pH/high GDP dialysate in assessments of peritoneal membrane function.
Parikova
Alena
A
Division of Nephrology, Department of Medicine, Academic Medical Center, University of Amsterdam, Amsterdam. Alenaparikova@hotmail.com
Struijk
Dirk G
DG
Zweers
Machteld M
MM
Langedijk
Monique
M
Schouten
Natalie
N
van den Berg
Nicole
N
Duis
Saskia
S
Krediet
Raymond T
RT
D000328:Adult; D001692:Biological Transport; D001826:Body Fluids / Q000378:metabolism; D002853:Chromatography, Liquid; D003404:Creatinine / Q000378:metabolism; D015314:Dialysis Solutions / Q000737:chemistry*; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D010537:Peritoneum / Q000378:metabolism*; D010539:Permeability; D011506:Proteins / Q000378:metabolism; D012964:Sodium / Q000378:metabolism; D014462:Ultrafiltration; D014508:Urea / Q000378:metabolism; D014527:Uric Acid / Q000378:metabolism
D015314:Dialysis Solutions; D011506:Proteins; D014527:Uric Acid; D014508:Urea; D012964:Sodium; D003404:Creatinine; D005947:Glucose