Changes in Peritoneal Equilibration Test Values during Long-Term Peritoneal Dialysis in Peritonitis-Free Children

Yoshino, Atsunori; Honda, Masashi; Fukuda, Masakazu; Araki, Yoshinori; Hataya, Hiroshi; Sakazume, Satoru; Tanaka, Yuriko; Kawamura, Ken; Murai, Tatsuya; Kamiyama, Youichi

doi:10.1177/089686080102100212

Cited by 21 publications

(8 citation statements)

References 24 publications

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“…One potential problem with their study is that the time intervals between the two PETs varied considerably, with a mean interval of 29.3 ± 21.6 months (11). While Yoshino et al also investigated the natural change in PET values during long-term PD treatment, their data focused on that of peritonitis-free children only (12). Our present study is the first to compare the longitudinal changes of peritoneal transport in adult patients with up to 3 years of uneventful CAPD therapy.…”

Section: Discussionmentioning

confidence: 89%

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Longitudinal Changes of Solute Transport in Peritonitis‐free Peritoneal Dialysis Patients

Hung

Chiou

et al. 2004

Artificial Organs

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Section: Discussionmentioning

confidence: 89%

“…While Yoshino et al. also investigated the natural change in PET values during long‐term PD treatment, their data focused on that of peritonitis‐free children only (12). Our present study is the first to compare the longitudinal changes of peritoneal transport in adult patients with up to 3 years of uneventful CAPD therapy.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Changes of Solute Transport in Peritonitis‐free Peritoneal Dialysis Patients

Hung

Chiou

et al. 2004

Artificial Organs

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“…Initially, we suspected that a rise in V→M permeability could be related to the natural course of treatment with CAPD, because increments in peritoneal permeability during the course of PD have been reported (16-19). However, D/P ratios and K BD ‘s for urea and creatinine were not significantly changed during the course of CAPD treatment in the control group, showing dialysis duration and comparable peritoneal permeability at the study onset similar to patients in the PG-DS group.…”

Section: Discussionmentioning

confidence: 99%

Results of Peritoneal Equilibration Test during Treatment with Polyglucose Dialysis Solution

Grzegorzewska

D²,

Leander

2002

Perit Dial Int

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Background Results of peritoneal equilibration test (PET) suggest prolonged effect of polyglucose dialysis solution (PG-DS) on peritoneal permeability. Objectives An evaluation of dialysate-to-plasma ratio (D/P) of urea, D/P creatinine, and D/D0 glucose (ratio of dialysate glucose at designated dwell time to dialysate glucose at 0 dwell time), and mass transfer area coefficients (KBD) of these solutes in PET before introduction, during administration, and after discontinuation of PG-DS in patients treated with continuous ambulatory peritoneal dialysis (CAPD). Design Single-center prospective study with PG-DS; retrospective selection of the control group. Setting Peritoneal dialysis unit in a university hospital. Patients Fourteen patients (11 males; age 45.1 ± 8.5 years) treated with CAPD for 17.5 ± 9.9 months. 7.5% PG-DS was used for the overnight exchange. After discontinuation of the PG-DS, standard dialysis solutions, as previously used, were reintroduced. The control group was selected to match both CAPD duration and peritoneal permeability of the patients in the PG-DS group at the start of the study. Methods Standard PET was carried out at 1.6 ± 0.8 months before the introduction of PG-DS (study period I, n = 14), after 1.2 ± 0.6 months’ use of PG-DS (study period II, n = 14), after 4.4 ± 0.8 months’ use of PG-DS (study period III, n = 11), after 8.8 ± 2.2 months’ use of PG-DS (study period IV, n = 9), and at 2.0 ± 0.6 months after PG-DS discontinuation (study period V, n = 11). Patients in the control group underwent PET at similar time intervals (control periods I – V). Results In the PG-DS group, a tendency toward increased peritoneal permeability for urea and creatinine was shown during the consecutive study periods. D/D0 glucose was significantly higher only in the PET performed during use of PG-DS (periods II – IV) compared to results obtained in period I. In the control group, both D/P and KBD of both urea and creatinine remained unchanged, but KBD glucose was higher in the first 2 hours of the PET in control period V compared to respective values in control period III. Conclusion Changes in peritoneal permeability are observed in CAPD patients treated with PG-DS. These changes may be at least partially related to the administration of polyglucose.

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“…They, however, contain high amounts of glucose and toxic glucose degradation products (GDPs) and expose the patient to supraphysiological lactate concentrations at an unphysiologically low pH. These PD solutions impair peritoneal mesothelial cell function and local host defence [ 51 , 52 ] and lead to profound alterations of PD membrane morphology and function within few years [ 50 , 53 ].…”

Section: Improving Pd Biocompatibilitymentioning

confidence: 99%

Peritoneal Dialysis Tailored to Pediatric Needs

Schmitt

Zaloszyc²,

Betti

et al. 2011

International Journal of Nephrology

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Consideration of specific pediatric aspects is essential to achieve adequate peritoneal dialysis (PD) treatment in children. These are first of all the rapid growth, in particular during infancy and puberty, which must be accompanied by a positive calcium balance, and the age dependent changes in body composition. The high total body water content and the high ultrafiltration rates required in anuric infants for adequate nutrition predispose to overshooting convective sodium losses and severe hypotension. Tissue fragility and rapid increases in intraabdominal fat mass predispose to hernia and dialysate leaks. Peritoneal equilibration tests should repeatedly been performed to optimize individual dwell time. Intraperitoneal pressure measurements give an objective measure of intraperitoneal filling, which allow for an optimized dwell volume, that is, increased dialysis efficiency without increasing the risk of hernias, leaks, and retrofiltration. We present the concept of adapted PD, that is, the combination of short dwells with low fill volume to promote ultrafiltration and long dwells with a high fill volume to improve purification within one PD session. The use of PD solutions with low glucose degradation product content is recommended in children, but unfortunately still not feasible in many countries.

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Changes in Peritoneal Equilibration Test Values during Long-Term Peritoneal Dialysis in Peritonitis-Free Children

Cited by 21 publications

References 24 publications

Longitudinal Changes of Solute Transport in Peritonitis‐free Peritoneal Dialysis Patients

Longitudinal Changes of Solute Transport in Peritonitis‐free Peritoneal Dialysis Patients

Results of Peritoneal Equilibration Test during Treatment with Polyglucose Dialysis Solution

Peritoneal Dialysis Tailored to Pediatric Needs

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