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Part 6: Peritoneal Transport |
Japanese Study Group of Pediatric Peritoneal Dialysis
Correspondence to: Yoshitsugu Kaku, Department of Nephrology, Fukuoka
Children's Hospital, Tohjinmachi 2-5-1, Chuo-ku, Fukuoka 810-0063
Japan.
y_kaku{at}nifty.com
Objective: To establish a standardized method and standard
values of peritoneal equilibration test (PET) in children and to elucidate the
factors influencing peritoneal permeability, we standardized the method of PET
in the leading hospitals of the Japanese Study Group of Pediatric Peritoneal
Dialysis.
Methods: Using 2.5% glucose dialysate and an infusion
volume of 1100 mL/m2 body surface area (BSA), we performed 202
standardized PETs. The patients within 1 month of a peritonitis episode were
excluded.
Results: The-1 standard deviation (SD), mean, and +1 SD
values of end dialysate-to-initial dialysate ratio of (D/D0)
glucose were 0.31, 0.41, and 0.51 respectively. The dialysate-to-plasma ratios
(D/P) of creatinine were 0.52, 0.65, and 0.78. These values were similar to
those of Twardowski's adult PET, although previous reports about standardized
pediatric PET described more permeable values. Because the duration of PD was
longer in the study patients, peritoneal permeability was increased
significantly in patients with and without experience of peritonitis alike.
The slope indices of the regression equations between the duration of PD and
peritoneal permeability in the two groups were same.
Conclusions: Standardized PET in Japanese children with
2.5% glucose dialysate and an infusion volume of 1100 mL/m2 BSA
produces standard values similar to those of Twardowski's adult PET. This
standardized method of PET is suitable for pediatric PD patients, and
peritoneal permeability in children is not higher than that in adults. In
addition, the study data show that long-term peritoneal dialysis worsens
peritoneal function more than experience of peritonitis does.
KEY WORDS: Peritoneal equilibration test; children; peritonitis; dialysis duration.
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