Introduction

Regular measurement of Kt/V and creatinine clearance (Crea-Cl) is suggested in peritoneal dialysis (PD) in order to document sufficient depuration.

Peritoneal membrane transport status by a PET test is carried out less frequently.

The aim of the study is to estimate the membrane transport status from peritoneal clearance measurements.

Patients and methods

D/P creatinine was calculated by PET and by peritoneal clearance measurements in patients under automated (APD: 244 measurements in 125 patients) and continuous ambulatory PD (CAPD: 84 measurements in 45 patients).

APD patients presented 24-hour dialysate volume of 7535 ml up to 28416 ml (mean±SD 15793±3222 ml, median 15000ml) whereas CAPD patients respectively of 4900 ml up to 15000 ml (mean±SD 8361±1906 ml, median 8500 ml).

Correlation matrices for the two PD modalities were elaborated.

Results

D/P creatinine by peritoneal clearance measurements correlated significantly to D/P creatinine by PET (APD: r=0.62, p<0.001; CAPD: r=0.62, p<0.001).

Patients with fast peritoneal membrane transport type in PET presented significantly higher D/P creatinine in peritoneal dialysate collections (APD: mean±SD 0.40±0.08, median 0.42; CAPD: mean±SD 0.84±0.18, median 0.84) in confront to patients with slow transport type in PET (APD: mean±SD 0.24±0.07, median 0.23; CAPD: mean±SD 0.60±0.07, median 0.58).

Conclusions

Peritoneal transport status can be estimated from peritoneal clearance measurements in APD and CAPD.

From a clinical viewpoint, the calculation of D/P creatinine from peritoneal clearance measurements might be helpful to distinguish between fast and slow peritoneal membrane transport status, even without having previously performed a PET.

References

Rocco MV, Jordan JR, Burkart JM. 24-hour dialysate collection for determination of peritoneal membrane transport characteristics: Longitudinal follow-up data for the dialysis adequacy and transport test (DATT). Perit Dial Int 1996; 16: 590-593.