title: Peritoneal total protein transport assessed from peritoneal equilibration tests using different dialysate glucose concentrations.
abstract: BACKGROUND
  The peritoneal equilibration test (PET) permits assessment of peritoneal protein transport, but this potential marker of outcome in peritoneal dialysis (PD) patients lacks adequate standardization. ♢
  
  
  OBJECTIVE
  To assess various approaches for estimation of peritoneal protein transport in PD patients during 2.27% and 3.86% glucose-based PETs, and to uncover the demographic, clinical, and biochemical correlates of this phenomenon. ♢
  
  
  METHODS
  We studied 90 PD patients who underwent 2.27% and 3.86% PETs in random order, and we used multivariate analysis to compare assessments of peritoneal protein transport in both tests, searching for correlations between D₂₄₀' - D₀' protein concentration (PETΔPConc), total peritoneal protein excretion (PET-PPE), or total protein clearance (PET-PC) on the one hand (the main study variables), and PET-derived markers of peritoneal function and selected demographic, clinical, and biochemical variables on the other. ♢
  
  
  RESULTS
  The PETΔPConc was higher during the 2.27% PET (mean: 45.2 mg/dL vs 37.0 mg/dL for the 3.86% test; p = 0.003); the PET-PPE and PET-PC were comparable (1121.8 mg vs 1168.9 mg, p = 0.52, and 17.1 mL vs 17.8 mL, p = 0.66, respectively). All three variables sustained a significant, yet moderate correlation (all r² values < 0.30) with the 24-hour PPE rate. Multivariate analysis identified dialysate-to-plasma ratio (D/P₂₄₀') of creatinine, end-to-initial dialysate ratio (D₂₄₀'/D₀') of glucose, current daily peritoneal glucose load, ultrafiltration during PET, systolic blood pressure, and previous cardiovascular events (3.86% test only) as independent predictors of protein transport during PET. ♢
  
  
  CONCLUSIONS
  Either PET-PPE or PET-PC seems preferable to PETΔPConc for characterization of peritoneal protein transport. Small-solute transport characteristics, ultrafiltration, and current peritoneal glucose load sustain independent correlations with peritoneal protein transport. The latter variable shows also a moderate association with markers of cardiovascular disease in PD patients.
authors.affiliation: Division of Nephrology, Complejo Hospitalario Universitario de A Coruña, Spain.
authors.forename: Ana Marta
authors.initials: AM
authors.lastname: Gomes
authors.forename: Miguel
authors.initials: M
authors.lastname: Pérez-Fontán
authors.forename: Ana
authors.initials: A
authors.lastname: Rodríguez-Carmona
authors.forename: Andrés
authors.initials: A
authors.lastname: López-Muñiz
authors.forename: Marcos
authors.initials: M
authors.lastname: Fernández-Villar
authors.forename: Javier
authors.initials: J
authors.lastname: Peteiro-Cartelle
authors.forename: Teresa
authors.initials: T
authors.lastname: García-Falcón
mesh_terms: D000136:Acid-Base Equilibrium / Q000502:physiology; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000032:analysis; D016009:Chi-Square Distribution; D019963:Clinical Chemistry Tests / Q000379:methods*; D015331:Cohort Studies; D015314:Dialysis Solutions / Q000032:analysis* / Q000378:metabolism*; D005260:Female; D005947:Glucose / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000379:methods*; D010537:Peritoneum / Q000378:metabolism*; D011446:Prospective Studies; D021381:Protein Transport / Q000502:physiology; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D015314:Dialysis Solutions; D005947:Glucose