Comparison of peritoneal equilibration test with 2.27% and 3.86% glucose dialysis solution
Cara, M.; Virga, G.; Mastrosimone, S.; Girotto, A.; Rossi, V.; D'Angelo, A.; Bonfante, L.
Journal of Nephrology 18(1): 67-71
2005
ISSN/ISBN: 1121-8428 PMID: 15772925 Document Number: 592340
Background: The standard Peritoneal Equilibration Test (PET) uses a 2.27% glucose dialysis solution in peritoneal dialysis (PD). A more hypertonic solution (3.86%) has recently been proposed to obtain further information about ultrafiltration (UF).Aim: To compare results in terms of peritoneal solute transport (4h-dialysate-to-plasma ratio, 4h-D/P) between 2.27% and 3.86% PET.Design: 23 patients on PD were randomized to form two groups, A and B. A 2.27% dextrose 2-1, exchange was used in group A, followed on the same day by a 3.86% dextrose 2-1, exchange, both with a 4-hour dwell (2.27% and 3.86% PET); in group B, the same treatment was administered in reverse. 4h-D/P of urea, creatinine and sodium at time 0, 60, 120 and 240 minutes and net LT were calculated for each PET and compared.Results: No significant statistical differences were found for the usual peritoneal transport indexes, 4h-D/P of urea and creatinine, between 2.27% and 3.86% PET, which produced almost identical results. The creatinine 4h-D/P were 0.67 +/- 0.09 vs. 0.66 +/- 0.10 (p=NS) and the urea 4h-D/P 0.91 +/- 0.04 vs. 0.90 +/- 0.04 (p=NS). The sodium D/P was lower at all times during the 3.86% PET: D/P60=0.92 +/- 0.05 vs. 0.88 +/- 0.03, D/P-120 = 0.91 +/- 0.02 vs. 0.87 +/- 0.03, D/P-240 = 0.92 +/- 0.02 vs. 0.88 +/- 0.04 (p < 0.0001). The net LT was 478 +/- 175 vs. 936 +/- 233 mL respectively (p < 0.0001).Conclusion: Our study suggests that a 3.86% PD solution could be used for PET instead of the 2.27% solution in order to assess peritoneal solute transport, as well as LTE, while obtaining almost identical results as the 2.27% solution.