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Perit Dial Int 26(5): 587-592 2006
© 2006 International Society for Peritoneal Dialysis
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Clinical

NO SIGNIFICANT DIFFERENCES IN PERITONEAL FLUID HANDLING IN CHILDREN USING pH-NEUTRAL OR ACIDIC SOLUTIONS

Peter Nourse1,2, Nicole C.A.J. van de Kar3, Hans L. Willems4 and Cornelis H. Schröder1

Department of Pediatric Nephrology,1 University Medical Center, Utrecht, The Netherlands; Department of Pediatric Nephrology,2 Tygerberg Children's Hospital, Tygerberg, South Africa; Department of Pediatric Nephrology3 and Department of Clinical Chemistry,4 University Medical Center, Nijmegen, The Netherlands

Correspondence to: P. Nourse, PO Box 19063, Tygerberg 7505, South Africa. nourse{at}sun.ac.za

{diamondsuit} Objectives: Differences in peritoneal fluid handling in the acute setting can be expected if children are converted to pH-neutral dialysis solutions because conventional acidic solutions exert toxic effects on peritoneal mesothelial cells and microcirculation. Peritoneal fluid kinetics was therefore investigated with both types of solutions in a group of children.

{diamondsuit} Design: Peritoneal equilibration tests (PETs) were performed in 12 patients [mean age 70 months, mean time on peritoneal dialysis (PD) 18 months] using a pH-neutral PD fluid (Physioneal 3.86%; Baxter Ltd, Castlebar, Ireland) and dextran 70 as a volume marker. The results of these PETs were compared to those of a historic group of 12 children (mean age 75 months, mean time on PD 17 months).

{diamondsuit} Setting: Pediatric dialysis unit in a tertiary institute.

{diamondsuit} Patients: Stable pediatric PD patients.

{diamondsuit} Main Outcome Measures: Transcapillary ultrafiltration (TCUF) and marker clearance, dialysate-to-plasma (D/P) ratios for urea and creatinine, and Dt/D0 ratio for glucose.

{diamondsuit} Results: TCUF and lymphatic absorption were not different between the two groups. There was also no significant difference in small solute clearance measured by D/P ratio for urea and creatinine and Dt/D0 ratio for glucose.

{diamondsuit} Conclusion: Peritoneal fluid kinetics is not significantly altered if pH-neutral dialysis solutions are applied compared to acidic solutions. An altered TCUF, as is hypothetically possible using an acidic solution, was not established.

KEY WORDS: Peritoneal equilibration test; children; pH-neutral dialysis solution.

Received 8 March 2005; accepted 2 March 2006.






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