Longitudinal evaluation of transport kinetics in children receiving peritoneal dialysis

Pediatr Nephrol. 1999 Sep;13(7):571-6. doi: 10.1007/s004670050745.

Abstract

Functional stability of the peritoneal membrane is necessary for maintenance of peritoneal dialysis (PD) as a therapeutic option. Few studies have investigated this issue in children. We evaluated the peritoneal membrane solute transport capacity longitudinally in 26 children (mean age 11.0+/-5.5 years) receiving long-term PD. Each patient underwent a standardized peritoneal equilibration test on two occasions (mean interval between studies 19.8+/-5.9 months) to determine solute dialysate to plasma (D/P) ratios, dialysate glucose to initial dialysate glucose (D/D(0)) ratios, and mass transfer area coefficients (MTAC). The correlation of transport capacity with peritonitis history was also assessed. No significant change in MTAC, D/P, or D/D(0) values were found when comparing original and follow-up data of the group overall. However, transport of creatinine and glucose was significantly (P<0.05) greater in the peritonitis group compared with the group without peritonitis, and differences in the change over time between the peritonitis groups was significant for MTAC creatinine (P=0.035) and D/D(0) glucose (P=0.020). In summary, this experience demonstrates functional stability of the peritoneal membrane in pediatric patients receiving PD. However, follow-up assessments of peritoneal solute kinetics may be necessary in patients with a history of peritonitis in order to permit early identification of those who may be at risk for ultrafiltration failure and sclerosing peritonitis.

MeSH terms

  • Adolescent
  • Biological Transport
  • Blood Glucose / analysis
  • Child
  • Child, Preschool
  • Creatinine / analysis
  • Creatinine / blood
  • Dialysis Solutions / chemistry
  • Glucose / analysis
  • Humans
  • Kinetics
  • Longitudinal Studies
  • Membranes / metabolism
  • Peritoneal Dialysis*
  • Peritoneum / metabolism*
  • Peritonitis / metabolism
  • Urea / analysis
  • Urea / blood

Substances

  • Blood Glucose
  • Dialysis Solutions
  • Urea
  • Creatinine
  • Glucose