Measurement of Peritoneal Fluid Handling in Children on Continuous Ambulatory Peritoneal Dialysis Using Autologous Hemoglobin

Reddingius, Roel E.; Schröder, Cornelis H.; Willems, Hans L.; Brandt, F.C.; Koomen, G. C. M.; Krediet, Raymond T.; Monnens, L.A.H.

doi:10.1177/089686089401400108

Cited by 11 publications

(6 citation statements)

References 16 publications

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“…We did not find changes in peritoneal fluid transport parameters between children and adults when corrected for BSA in both groups. This is in agreement with the study of Reddingius et al (37). The D/P ratios in children overestimated the MTAC values in the lower ranges and underestimated them in the higher ranges.…”

Section: Comparison Of Children With Adultssupporting

confidence: 93%

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Standard Peritoneal Permeability Analysis in Children

Bouts¹,

Davin²,

Groothoff³

et al. 2000

Journal of the American Society of Nephrology

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Abstract. Peritoneal transport characteristics in children on peritoneal dialysis (PD) has been reported to be different compared to adults. However, various test methods can influence this difference. Thirty-one standard peritoneal permeability analyses (SPA) were performed in 18 PD children with a median (range) age of 9.8 yr (2 to 19) and a median duration of PD of 2.6 yr (0.19 to 6.8). The median mass transfer area coefficient (MTAC) for creatinine was 9.6 ml/min per 1.73 m2 (4.4 to 18.0), and for urea 17.3 ml/min per 1.73 m2 (12.2 to 22.8). The median dialysate to plasma creatinine ratio (D/PCr) was 0.69 (0.44 to 0.92), the glucose absorption 59% (23 to 75), and the D/D0 for glucose 0.38 (0.23 to 0.62). The median clearance of β2-microglobulin was 923 μl/min per 1.73 m2 (366 to 1828), of albumin 103 μl/min per 1.73 m2 (55 to 211), of IgG 48 μl/min per 1.73 m2 (20 to 105), and of α2-macroglobulin 12 μl/min per 1.73 m2 (5 to 49). No correlation was found between these results and age or PD time. The restriction coefficient for macromolecules indeed increased with duration of PD treatment (r = 0.38, P = 0.03). The median transcapillary ultrafiltration rate was 1.2 ml/min per 1.73 m2 (-0.01 to 2.8), the net ultrafiltration rate 0.2 ml/min per 1.73 m2 (-1.97 to 1.82), and the effective lymphatic absorption rate 1.04 ml/min per 1.73 m2 (-0.06 to 2.91). When corrected for body surface area, no differences were found in peritoneal fluid and solute transport characteristics between children and adults. No effect of time on PD on the transport parameters was found in a cross-sectional analysis, except for an increase of the restriction coefficient to macromolecules. This finding is similar to observations in adults. Therefore, the present study showed no evidence for the common belief that the peritoneal membrane in children is different from that in adult patients.

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Section: Comparison Of Children With Adultssupporting

confidence: 93%

“…No influence of age on the fluid kinetic parameters was found when cor-rected for BSA. Similar findings have been described by Reddingius et al (37).…”

Section: Relationship Between Transport Parameters and Agesupporting

confidence: 92%

Standard Peritoneal Permeability Analysis in Children

Bouts¹,

Davin²,

Groothoff³

et al. 2000

Journal of the American Society of Nephrology

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“…In a group of 9 children (median age 4.2 years; range 1.7 -10.9 years), we studied the influence of a 3.86% glucose solution and a 7.5% icodextrin solution on IPP and the change in IPP in relation to fluid kinetics. Two PETs were performed in each child, as described previously (11); one PET was performed with a 3.86% glucose solution (Dianeal) and the other with a 7.5% icodextrin solution (Extraneal; Baxter BV). The 4-hour dwell was performed with an IPV of 1200 mL/m 2 BSA, and dextran 70 (Macrodex; NPBI, Emmercompascuum, The Netherlands) was added to the test solution as volume marker to calculate fluid kinetics.…”

Section: Influence Of Different Dialysis Fluids On Ippmentioning

confidence: 99%

“…Transcapillary ultrafiltration (TCUF), marker clearance (MC), and net ultrafiltration (UF) were calculated according to previously described formulas (11). In brief, TCUF was calculated from the dilution of the volume marker by subtracting the initial theoretical IPV from the theoretical IPV.…”

Section: Influence Of Different Dialysis Fluids On Ippmentioning

confidence: 99%

Evaluation of Intraperitoneal Pressure and the Effect of Different Osmotic Agents on Intraperitoneal Pressure in Children

et al. 2005

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Objectives To establish intraperitoneal pressure (IPP) in a relatively large pediatric study group and to study the effects of a 3.86% glucose solution and a 7.5% icodextrin solution on IPP during a 4-hour dwell. Design IPP was measured with the patient in a supine position. The intraperitoneal volume (IPV) was 1200 mL/m2 with a 1.36% glucose solution. The influence of dialysis solutions was obtained by performing two 4-hour peritoneal equilibration tests (PETs) with 3.86% glucose and 7.5% icodextrin as test solution, using an IPV of 1200 mL/m2 and dextran 70 as volume marker. IPP was measured at two consecutive time points ( t = 0 and t = 240 minutes). Transcapillary ultrafiltration, net ultrafiltration, and marker clearance were calculated. Patients IPP was established in 30 patients with median age of 4.5 years (range 1.0 – 14.9 years). Influence of dialysis solutions on IPP was studied in 9 children with median age of 4.2 years (range 1.7 – 10.9 years) and median treatment period of 12 months (range 5.6 – 122.3 months). Results Mean IPP was 12.0 ± 6.5 cm H2O. Significant relations were found between the change in IPP and transcapillary ultrafiltration and body surface area during the PET with 3.86% glucose. No relations were seen during the PET with icodextrin. Conclusions IPP was established in a large pediatric study group and was similar to previously published values of IPP in a small number of patients. Differences in fluid kinetics have different effects on the change in IPP during a 4-hour dwell period.

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“…In this test, polydisperse dextran-70 is added to the PD solution employed in the PET so that simultaneous measurement is obtained of transcapillary ultrafiltration (UF), marker clearance rates, and intraperitoneal volume (IPV). Standard permeability analysis (SPA) conducted with a test IPV of 1,200 ml/m 2 and a 1.36% or 3.86% glucose PD solution gave comparable results in adult and pediatric patients [ 19 , 20 ].…”

Section: Peritoneal Membrane Function Testsmentioning

confidence: 99%

Selection of modalities, prescription, and technical issues in children on peritoneal dialysis

2009

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Peritoneal dialysis (PD) is widely employed as a dialytic therapy for uraemic children, especially in its automated form (APD), that is associated with less burden of care on patient and family than continuous ambulatory PD. Since APD offers a wide range of treatment options, based on intermittent and continuous regimens, prescription can be individualized according to patient's age, body size, residual renal function, nutritional intake, and growthrelated metabolic needs. Transport capacity of the peritoneal membrane of each individual patient should be assessed, and regularly monitored, by means of standardized peritoneal function tests validated in pediatric patients. To ensure maximum recruitment of peritoneal exchange area, fill volume should be scaled to body surface area and adapted to each patient, according to clinical tolerance and intraperitoneal pressure. PD solutions should be employed according to their biocompatibility and potential ultrafiltration capacity; new pH-neutral, glucose-free solutions can be used in an integrated way in separate dwells, or by appropriately mixing during the same dialytic session. Kinetic modelling software programs may help in the tailoring of PD prescription to individual patients' characteristics and needs. Owing to advances in the technology of new APD machines, greater programming flexibility, memorized delivery control, and tele-dialysis are currently possible.

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Measurement of Peritoneal Fluid Handling in Children on Continuous Ambulatory Peritoneal Dialysis Using Autologous Hemoglobin

Cited by 11 publications

References 16 publications

Standard Peritoneal Permeability Analysis in Children

Standard Peritoneal Permeability Analysis in Children

Evaluation of Intraperitoneal Pressure and the Effect of Different Osmotic Agents on Intraperitoneal Pressure in Children

Selection of modalities, prescription, and technical issues in children on peritoneal dialysis

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