Hydration status does not influence peritoneal equilibration test ultrafiltration volumes.
OBJECTIVE
The peritoneal equilibration test (PET) was developed some 25 yr ago and has been used to help prescribe peritoneal dialysis. However, PET is affected by several factors, including diabetes and inflammation. It was speculated that extracellular fluid overload would increase PET ultrafiltration volumes, and therefore the usefulness of the PET in routine clinical practice was audited.


METHODS
Data from 211 consecutive patients attending a university teaching hospital for a standard PET who had multifrequency bioimpedance performance were analyzed to determine which factors affected net PET ultrafiltration volumes.


RESULTS
Net PET ultrafiltration volume was independent of gender, age, diabetes, residual renal function, peritoneal dialysis prescriptions (modes and dialysates), extracellular fluid volume, or C-reactive protein (CRP). There was an inverse regression with serum albumin and sodium on multiple logistical regression analysis (F = 13.4, P < 0.001 and F = 10.1, P = 0.001, respectively) and a positive regression with 24-h net peritoneal ultrafiltration volumes (F = 15.5, P < 0.001). As expected, there was a strong correlation with net sodium losses (r = 0.99, P < 0001).


CONCLUSIONS
It was found that PET test ultrafiltration volume in routine clinical practice was not affected by CRP, hyperglycemia, or extracellular fluid volume overload. Ultrafiltration volumes were increased in those patients with reduced serum sodium and albumin, most likely because of inflammation and protein malnutrition.
Davenport
Andrew
A
University College London Center for Nephrology, University College London Medical School, London, UK. Andrew.davenport@royalfree.nhs.uk
Willicombe
Michelle Kay
MK
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001810:Blood Volume / Q000502:physiology; D002097:C-Reactive Protein / Q000378:metabolism; D015314:Dialysis Solutions; D017097:Electric Impedance; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000503:physiopathology; D007249:Inflammation / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D008954:Models, Biological; D010530:Peritoneal Dialysis / Q000379:methods*; D011502:Protein-Energy Malnutrition / Q000503:physiopathology; D012709:Serum Albumin / Q000378:metabolism; D012964:Sodium / Q000097:blood; D014883:Water-Electrolyte Imbalance / Q000175:diagnosis* / Q000503:physiopathology*; D055815:Young Adult
D015314:Dialysis Solutions; D012709:Serum Albumin; D002097:C-Reactive Protein; D012964:Sodium