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Perit Dial Int 30(1): 91-94
2010
© 2010 International Society for Peritoneal Dialysis
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Clinical

COMPARISON OF THE MULTIPLE-ALIQUOT AND BATCH METHODS OF MONITORING PERITONEAL DIALYSIS ADEQUACY IN PATIENTS

Andrew W. Lyon1,2, Janice James3, Christine Lemaire2 and Bruce Culleton4,5

Department of Pathology and Laboratory Medicine,1 University of Calgary; Calgary Laboratory Services,2 Division of Nephrology,3 Calgary Health Region; Department of Medicine,4 University of Calgary, Calgary, Alberta, Canada; Baxter Healthcare,5 Deerfield, Illinois, USA

Correspondence to: A.W. Lyon, Department of Pathology and Laboratory Medicine, University of Calgary & Calgary Laboratory Services, 9, 3535 Research Road NW, Calgary, Alberta T2K 2K8 Canada. alyon{at}ucalgary.ca

{diamondsuit} Background: Effluent fluid is analyzed to determine Kt/V urea and creatinine clearance as measures of adequacy of peritoneal dialysis. To avoid the physical mixing of fluids and to minimize handling of full effluent bags, a multiple-aliquot method of sampling was developed and compared to the traditional batch method.

{diamondsuit} Methods: The batch method and the multiple-aliquot method were performed for 31 consecutive patients. Pooled fluid urea and creatinine measurements were determined for each method. PD Adequest 2.0 (Baxter Healthcare, Deerfield, IL, USA) was used to derive calculated peritoneal dialysis parameters.

{diamondsuit} Results: Urea dialysate levels, calculated weekly urea clearances, protein catabolic rate, and Kt/V were not statistically different (p > 0.05) between the 2 methods. Dialysate creatinine and creatinine clearance with the 2 methods were statistically distinct but the differences were not clinically important. The processing time per set of patient effluent bags was reduced from 45 to 18 minutes, handling of the bags was minimized, and error associated with inadequate mixing of pooled fluids was avoided.

{diamondsuit} Conclusion: The multiple-aliquot method generates accurate and timely results to assess peritoneal dialysis prescription adequacy while reducing staff effort.

KEY WORDS: Adequacy; peritoneal equilibrium test.

Received 1 October 2008; accepted 6 February 2009.






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