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ESTIMATION OF PERITONEAL MEMBRANE TRANSPORT CHARACTERISTICS FROM 24-HOUR PERITONEAL DIALYSATE COLLECTIONS

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Razionale

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.

Casistica e Metodi

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.

Risultati

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). D/P creatinine from peritoneal clearance was not related to dialysate volume neither in CAPD nor APD.

Conclusioni

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.

Zeiler M., Marani M.*, Agostinelli RM., Monteburini T., Marinelli R., Di Luca M.*, Santarelli S.
(U.O. Nefrologia e Dialisi, Ospedale "Carlo Urbani", Jesi (AN); *U.O. Nefrologia e Dialisi, Ospedale "San Salvatore", Pesaro (PU))
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