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Perit Dial Int 27(6): 691-696 2007
© 2007 International Society for Peritoneal Dialysis
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Clinical

DOES THE BIOCOMPATIBILITY OF THE PERITONEAL DIALYSIS SOLUTION MATTER IN ASSESSMENT OF PERITONEAL FUNCTION?

Alena Parikova1, Dirk G. Struijk1,2, Machteld M. Zweers1, Monique Langedijk1,2, Natalie Schouten1,2, Nicole van den Berg1,2, Saskia Duis1,2 and Raymond T. Krediet1

Division of Nephrology,1 Department of Medicine, Academic Medical Center, University of Amsterdam, Amsterdam; Dianet Foundation Amsterdam-Utrecht,2 The Netherlands

Correspondence to: A. Parikova, Clinic of Nephrology, 1st Faculty of Medicine, Charles University, U nemocnice 2, 120 00 Prague 2, Czech Republic. Alenaparikova{at}hotmail.com

{diamondsuit} Background: Peritoneal function tests are performed in peritoneal dialysis (PD) patients to characterize peritoneal membrane status. A low pH/high glucose degradation product (GDP) dialysis solution is used as the test solution. The objective of the present study was to compare a 3.86% glucose, low pH/high GDP dialysis solution (pH 5.5) with a 3.86% glucose, normal pH/low GDP dialysis solution (pH 7.4) in assessments of peritoneal membrane function.

{diamondsuit} Methods: Two standard peritoneal permeability analyses (SPA) were performed in 10 stable PD patients within 2 weeks. One SPA was done with the 3.86% low pH/high GDP solution, and the other with the 3.86% normal pH/low GDP solution. The sequence of the two tests was randomized.

{diamondsuit} Results: Fluid transport parameters and glucose absorption were not different between the two groups. No differences were found for the mass transfer area coefficients (MTACs) of low molecular weight solutes calculated over the whole dwell. However, MTAC urea in the first hour of the dwell was higher in the test done with low pH/high GDP dialysate, suggesting more peritoneal vasodilation. No difference was found in protein clearances. Sodium sieving at multiple time points during the dwell was similar with the two solutions.

{diamondsuit} Conclusion: The results obtained with the glucose-containing normal pH/low GDP dialysis solution were similar to those obtained with the glucose-containing low pH/high GDP dialysate in assessments of peritoneal membrane function.

KEY WORDS: Assessment of peritoneal membrane function; biocompatible dialysis solution; solute transport; fluid kinetics; protein clearances; mesothelial cell mass marker CA125.

Received 18 April 2005; accepted 18 June 2007.






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