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Perit Dial Int 29(5): 523-527
2009
© 2009 International Society for Peritoneal Dialysis
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Clinical Sciences

QUANTIFICATION OF FREE WATER TRANSPORT DURING THE PERITONEAL EQUILIBRATION TEST

Trijntje T. Cnossen1, Watske Smit2, Constantijn J.A.M. Konings3, Jeroen P. Kooman1, Karel M. Leunissen1 and Raymond T. Krediet2

Divisions of Nephrology, Departments of Internal Medicine of Maastricht University Medical Center,1 Academic Medical Center,2 Amsterdam, and Catharina Hospital,3 Eindhoven, The Netherlands

Correspondence to: T.T. Cnossen, Division of Nephrology, Department of Internal Medicine, Maastricht University Medical Center, Postbus 5800, 6202 AZ Maastricht, The Netherlands. nynke.cnossen{at}mumc.nl

{diamondsuit} Objective: Free water transport (FWT) can be calculated after a dwell of 1 hour with a 3.86% glucose solution using sodium kinetics (mini-PET, as developed by LaMilia et al.). This requires measurement of the intraperitoneal volume after drainage of the abdomen. Since valuable information of a 4-hour peritoneal equilibration test (PET) may be lost, the aim of the present study was to investigate whether temporary drainage of the peritoneal cavity after 1 hour and re-instillation thereafter would influence the results of the 4-hour PET.

{diamondsuit} Methods and Patients: Two PETs were performed in 10 stable peritoneal dialysis (PD) patients (mean age 59 ± 13 years, mean duration on PD 33 ± 15 months) within a mean period of 54 (range 13 – 104) days: one standardized 4-hour PET using 3.86% glucose (PET A) and one with drainage after 1 hour followed by re-instillation (PET B).

{diamondsuit} Results: Mean total ultrafiltration (UF) of PETs A and B was 667 ± 210 mL and 621 ± 206 mL (NS). Mean FWT at 60 minutes was 164 ± 74 mL and mean UF through the small pores was 204 ± 181 mL; FWT correlated well with total UF (r = 0.720, p = 0.019). Classification of transport categories was identical for 9 of the 10 patients. Comparison of 1-hour and 4-hour results in test B showed a good correlation between dialysate-to-plasma ratios (D/P) of creatinine and urea and Dt/D0 ratios of glucose.

{diamondsuit} Conclusion: A 4-hour 3.86% glucose PET, including temporary drainage after 1 hour for assessment of free water transport, does not influence the results of D/P creatinine or Dt/D0 glucose and gives essential additional information on aquaporin function.

KEY WORDS: Aquaporin-1; free water transport; peritoneal equilibration test; sodium.

Received 15 May 2008; accepted 3 October 2008.






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