title: Factors effective on peritoneal phosphorus transport and clearance in peritoneal dialysis patients .
abstract: OBJECTIVE
  Transport characteristics of phosphorus are different from other small solutes that are evaluated in routine peritoneal equilibration test (PET) in peritoneal dialysis (PD) patients. We aimed to evaluate peritoneal phosphorus clearance and permeability, and their relationship with peritoneal membrane transport type and creatinine clearance as well as factors affecting peritoneal phosphorus clearance.
  
  
  METHODS
  70 adult patients on a PD program were included in our study. Phosphorus transport status was classified according to dialysate/plasma (D/P) phosphorus at the 4thhour of PET as slow transporter (< 0.47), slow-average transporter (0.47 - 0.56), fast-average transporter (0.57 - 0.67), and fast transporter (> 0.67). We evaluated the relationship of peritoneal phosphorus clearance and transport type with PD regime, phosphorus level, and presence of residual renal function in addition to investigating factors that are effective on peritoneal phosphorus clearance.
  
  
  RESULTS
  D/P phosphorus and peritoneal phosphorus clearance were positively correlated with D/P creatinine and peritoneal creatinine clearance, respectively. Automated PD and continuous ambulatory PD patients were similar regarding phosphorus and creatinine clearances and transport status based on D/P phosphorus. The major determinant of peritoneal phosphorus clearance was anuria status. Anuric patients had higher dialysate volume (11.6 ± 3.0 L vs. 8.4 ± 2.1 L, p < 0.001) and therefore higher peritoneal phosphorus clearance (61.7 ± 15.1 L/week/1.73 m2vs. 48.4 ± 14.0 L/week/1.73 m2, p = 0.001). Hyperphosphatemia was present in 40% and 11% of anuric patients and those with residual renal function, respectively (p = 0.005).
  
  
  CONCLUSIONS
  Peritoneal phosphorus transport characteristics are similar to that of creatinine. Although increased dialysis dose may increase peritoneal phosphorus clearance, it may be insufficient to prevent hyperphosphatemia in anuric patients. .
authors.forename: Egemen
authors.initials: E
authors.lastname: Cebeci
authors.forename: Meltem
authors.initials: M
authors.lastname: Gursu
authors.forename: Sami
authors.initials: S
authors.lastname: Uzun
authors.forename: Serhat
authors.initials: S
authors.lastname: Karadag
authors.forename: Rumeyza
authors.initials: R
authors.lastname: Kazancioglu
authors.forename: Savas
authors.initials: S
authors.lastname: Ozturk
mesh_terms: D000328:Adult; D001002:Anuria / Q000378:metabolism; D001692:Biological Transport; D005260:Female; D006801:Humans; D054559:Hyperphosphatemia / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D010531:Peritoneal Dialysis, Continuous Ambulatory; D010537:Peritoneum / Q000378:metabolism*; D010758:Phosphorus / Q000378:metabolism*
chemical_list: D010758:Phosphorus