Transport of peritoneal membrane assessed before and after the start of peritoneal dialysis.
BACKGROUND
Patients on peritoneal dialysis (PD) with high small solute peritoneal membrane transport have an increased risk of morbidity and mortality. The membrane transport is currently assessed by peritoneal equilibration test (PET), usually performed after the first month of PD because of the early increase of membrane transport after the start of PD. The aim of this study was the assessment of small solute peritoneal membrane transport before and after the start of PD.


METHODS
The small solute peritoneal membrane transport was evaluated in 34 patients before the start of PD. Twenty-two patients were treated with continuous ambulatory peritoneal dialysis (CAPD) and 12 with automated peritoneal dialysis (APD).


RESULTS
Four months after the start of PD, the small solute peritoneal membrane transport increased only in CAPD patients (D/P(Creat), the ratio between dialysate solute concentration at the end of the PET and creatinine plasma concentration, changed from 0.66 +/- 0.12 to 0.73 +/- 0.07 in CAPD patients and from 0.64 +/- 0.12 to 0.61 +/- 0.07 in APD patients), and after about 16 months of PD, the peritoneal membrane transport was higher in CAPD patients (D/P(Creat) = 0.74 +/- 0.06) than in APD patients (D/P(Creat) = 0.63 +/- 0.10).


CONCLUSIONS
Performing the PET before and after the start of PD could provide relevant information about the characteristics of small solute peritoneal membrane transport and could be useful to evaluate the influence of PD modality on the changes in peritoneal membrane transport.
Department of Nephrology and Dialysis, A. Manzoni Hospital, Lecco, Italy. v.lamilia@ospedale.lecco.it
Vincenzo
V
La Milia
Monica
M
Limardo
Andrea
A
Cavalli
Monica
M
Crepaldi
Francesco
F
Locatelli
D000368:Aged; D001693:Biological Transport, Active; D001786:Blood Glucose / Q000378:metabolism; D001798:Blood Proteins / Q000378:metabolism; D003404:Creatinine / Q000097:blood / Q000378:metabolism; D015314:Dialysis Solutions / Q000032:analysis; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D010531:Peritoneal Dialysis, Continuous Ambulatory; D010537:Peritoneum / Q000503:physiopathology*; D013997:Time Factors
D001786:Blood Glucose; D001798:Blood Proteins; D015314:Dialysis Solutions; D003404:Creatinine; D005947:Glucose