Estimation of peritoneal membrane transport characteristics from peritoneal clearance measurements

Introduction and Aim

Regular measurement of Kt/V and creatinine clearance is suggested in peritoneal dialysis (PD) in order to document sufficient depuration. Peritoneal membrane transport status by a peritoneal equilibration test (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 from PET and from peritoneal clearance measurements in patients under automated PD (APD: 244 measurements in 125 patients, patient age median 65 years) and continuous ambulatory PD (CAPD: 84 measurements in 45 patients, patient age median 73 years). APD patients presented 24-hour dialysate volume from 7535 ml to 28416 ml (median 15000ml) whereas CAPD patients respectively from 4900 ml to 15000 ml (median 8500 ml). Correlation matrices between D/P creatinine from PET versus peritoneal clearance measurements were elaborated for both PD modalities.

Results

D/P creatinine from peritoneal clearance measurements correlated significantly to D/P creatinine from 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 clearance measurements in confront to patients with slow transport type in PET.

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.