title: Measuring peritoneal absorption with the prolonged peritoneal equilibration test from 4 to 8 hours using various glucose concentrations.
abstract: BACKGROUND
  Peritoneal fluid flows such as small-pore ultrafiltration and free water transport can now be calculated by means of the modified peritoneal equilibration test (PET). To calculate peritoneal fluid absorption, volume markers have been used, but that method is not easily applicable in clinical practice. Alternatively, absorption can be estimated using the personal dialysis capacity test. However, a method of measuring overall peritoneal absorption together with the PET is lacking. The aim of the present study was to assess whether overall peritoneal absorption was different when measured from the 4th to 8th hour in a prolonged PET using three different glucose solutions.
  
  
  METHODS
  The study enrolled 32 stable peritoneal dialysis (PD) patients from a tertiary university hospital, who underwent three 8-hour prolonged PETs with 1.36%, 2.27%, and 3.86% glucose solution. The PETs were performed in random order over a period of less than 1 month. During the prolonged PET, the peritoneal volume was emptied and reinfused at 60 and 240 minutes and drained at 480 minutes. Peritoneal absorption was calculated as the volume difference between the 4th and the 8th hour.
  
  
  RESULTS
  The dialysate-to-plasma ratio (D/P) of urea, the D/P creatinine, and the mass transfer area coefficient (MTC) of creatinine at 240 minutes were not significantly different with the three glucose solutions. The end-to-initial (D/D0) glucose, MTC urea, and MTC glucose were significantly different. All water transport parameters were significantly different, except for the 4- to 8-hour absorption volumes and rates. The peritoneal absorption rates were, for 1.36% solution, 1.03 ± 0.58 mL/min [95% confidence interval (CI): 0.83 to 1.24 mL/min]; for 2.27% solution, 0.86 ± 0.71 mL/min (95% CI: 0.61 to 1.11 mL/min); and for 3.86% solution, 1.05 ± 0.78 mL/min (95% CI: 0.77 to 1.33 mL/min). Peritoneal absorption volumes and rates from the 4th to the 8th hour showed good correlations for the various solutions.
  
  
  CONCLUSIONS
  Using any glucose solution, the prolonged PET with voiding and reinfusion at the 4th hour could be a practical method for calculating overall peritoneal absorption from the 4th to the 8th hour in PD patients.
authors.affiliation: Nephrology Department, Hospital Universitari, and Fundació Institut d'Investigació en Ciències de la Salut, Germans Trias i Pujol, Barcelona, Spain Nephrology Department, Hospital Universitari, and Fundació Institut d'Investigació en Ciències de la Salut, Germans Trias i Pujol, Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Teixidó-Planas
authors.affiliation: Nephrology Department, Hospital Universitari, and Fundació Institut d'Investigació en Ciències de la Salut, Germans Trias i Pujol, Barcelona, Spain.
authors.forename: Maria Isabel
authors.initials: MI
authors.lastname: Troya-Saborido
authors.affiliation: Nephrology Department, Hospital Universitari, and Fundació Institut d'Investigació en Ciències de la Salut, Germans Trias i Pujol, Barcelona, Spain.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Pedreira-Robles
authors.affiliation: Nephrology Department, Hospital Universitari, and Fundació Institut d'Investigació en Ciències de la Salut, Germans Trias i Pujol, Barcelona, Spain.
authors.forename: Milagros
authors.initials: M
authors.lastname: Del-Rio-Lafuente
authors.affiliation: Nephrology Department, Hospital Universitari, and Fundació Institut d'Investigació en Ciències de la Salut, Germans Trias i Pujol, Barcelona, Spain.
authors.forename: Ramon
authors.initials: R
authors.lastname: Romero-Gonzalez
authors.affiliation: Nephrology Department, Hospital Universitari, and Fundació Institut d'Investigació en Ciències de la Salut, Germans Trias i Pujol, Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Bonet-Sol
mesh_terms: D000136:Acid-Base Equilibrium / Q000502:physiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001692:Biological Transport; D015331:Cohort Studies; D003404:Creatinine / Q000032:analysis; D015314:Dialysis Solutions / Q000378:metabolism*; D005260:Female; D005947:Glucose / Q000493:pharmacokinetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D065629:Peritoneal Absorption / Q000502:physiology*; D010530:Peritoneal Dialysis / Q000379:methods*; D010865:Pilot Projects; D012680:Sensitivity and Specificity; D013997:Time Factors; D055815:Young Adult
chemical_list: D015314:Dialysis Solutions; D003404:Creatinine; D005947:Glucose
keywords: Peritoneal absorption or reabsorption; peritoneal fluid flow pathways; peritoneal function test; peritoneal water transport