[Peritoneal equilibration test: Conventional versus adapted. Preliminary study].
Conventional automated peritoneal dialysis (APD) is prescribed as a repetition of cycles with the same dwell time and the same fill volume. Water and sodium balance remains a common problem among patients on peritoneal dialysis. More recently, adapted automated peritoneal dialysis was described, as a combination of short dwells with a low volume, in order to enhance ultrafiltration, followed by long dwells with a large fill volume to favor solute removal. We performed a preliminary crossover study on 4 patients. The total amount of dialysate was the same, i.e. 2L/m2as well as the total duration of the test, i.e. 150 minutes. The conventional test was made with two identical cycles, each cycle had a fill volume of 1L/m2and a duration of 75 minutes, while the adapted test was performed with one short cycle, i.e. 30 minutes with a low fill volume, i.e. 0.6L/m2, followed by a long cycle, i.e. 120 minutes, with a large fill volume, i.e. 1.4L/m2. Sodium extraction was improved by 29.3mmol/m2(169%) in the adapted test in comparison to the conventional test. Ultrafiltration was enhanced by 159mL/m2(128%) in the adapted test compared to the conventional one. Glucose absorption was decreased by 35% in the adapted test in comparison to the conventional test and osmotic conductance was also improved. In conclusion, adapted dialysis may allow for a better volume and sodium balance, since we observed an improvement in sodium extraction and ultrafiltration. This pre-study authorizes an improvement of the European Pediatric Study's protocol on Adapted APD, already started and which will continue in the next months.
Service de pédiatrie I, hôpitaux universitaires de Strasbourg, CHU de Hautepierre, 1, avenue Molière, 67098 Strasbourg, France. Electronic address: ariane.zaloszyc@chru-strasbourg.fr.
Ariane
A
Zaloszyc
Kinder Nephrologie, Uni-klinikum Heidelberg Zentrum für Kinder-Jugendmedizin, INF 430, 69120 Heidelberg, Allemagne.
Claus Peter
CP
Schmitt
Kinder Nephrologie, Uni-klinikum Heidelberg Zentrum für Kinder-Jugendmedizin, INF 430, 69120 Heidelberg, Allemagne.
Betti
B
Schaefer
Service de pédiatrie I, hôpitaux universitaires de Strasbourg, CHU de Hautepierre, 1, avenue Molière, 67098 Strasbourg, France.
Armelle
A
Doutey
Service de pédiatrie I, hôpitaux universitaires de Strasbourg, CHU de Hautepierre, 1, avenue Molière, 67098 Strasbourg, France.
Joëlle
J
Terzic
Service de pédiatrie I, hôpitaux universitaires de Strasbourg, CHU de Hautepierre, 1, avenue Molière, 67098 Strasbourg, France.
Soraya
S
Menouer
Service de pédiatrie I, hôpitaux universitaires de Strasbourg, CHU de Hautepierre, 1, avenue Molière, 67098 Strasbourg, France.
Laetitia
L
Higel
Service de pédiatrie I, hôpitaux universitaires de Strasbourg, CHU de Hautepierre, 1, avenue Molière, 67098 Strasbourg, France.
Michel
M
Fischbach
D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D015314:Dialysis Solutions / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D010530:Peritoneal Dialysis; D012964:Sodium / Q000378:metabolism
D001786:Blood Glucose; D015314:Dialysis Solutions; D012964:Sodium
Absorption de glucose; Adapted dialysis; Conventional dialysis; Dialyse adaptée; Dialyse conventionnelle; Extraction sodée; Glucose absorption; Sodium and water balance; Sodium extraction; Ultrafiltration; Équilibre hydrosodé