Time course of peritoneal transport parameters in peritoneal dialysis patients who develop peritoneal sclerosis

Adv Perit Dial. 2007;23:107-11.

Abstract

Peritoneal sclerosis (PS) is a severe complication of long-term peritoneal dialysis (PD). We therefore investigated whether longitudinal analysis of solute and fluid transport preceding a diagnosis of PS could predict its development. We reviewed all standard peritoneal permeability analyses (SPAs) performed with 3.86% glucose and completed before a diagnosis of PS in all patients (n = 11) in whom that diagnosis was made in our center between 1995 and 2006. Most patients had 4 SPAs available. A linear mixed-model procedure was used to analyze the trends. Transport of small-solutes showed significant inverse U-shaped trends before a diagnosis of PS. This trend held for the mass transport area coefficients of creatinine, urea, and urate (all p < 0.05) and for their dialysate-to-plasma ratios (all p < 0. 001). Net ultrafiltration and free water transport at 60 minutes showed significant downward linear trends (both p < or = 0. 01). This U-shaped trend in small-solute transport combined with an ongoing decrease in net ultrafiltration and free water transport might be a warning sign of the development of PS. It underlines the importance of regular assessment of peritoneal function with 3.86% peritoneal equilibration tests in every PD patient-not only those at risk for peritoneal membrane failure.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biological Transport
  • Creatinine / metabolism
  • Glucans
  • Glucose / pharmacokinetics
  • Hemodialysis Solutions
  • Humans
  • Icodextrin
  • Middle Aged
  • Peritoneal Dialysis / adverse effects*
  • Peritoneal Diseases / diagnosis
  • Peritoneal Diseases / etiology
  • Peritoneal Diseases / metabolism*
  • Peritoneum / metabolism*
  • Permeability
  • Sclerosis
  • Urea / metabolism
  • Uric Acid / metabolism

Substances

  • Glucans
  • Hemodialysis Solutions
  • Uric Acid
  • Icodextrin
  • Urea
  • Creatinine
  • Glucose