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NDT Advance Access published online on April 6, 2009
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfp151
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Transport of peritoneal membrane assessed before and after the start of peritoneal dialysis

Vincenzo La Milia, Monica Limardo, Andrea Cavalli, Monica Crepaldi and Francesco Locatelli

Department of Nephrology and Dialysis, A. Manzoni Hospital, Lecco, Italy

Correspondence and offprint requests to: Vincenzo La Milia; E-mail: v.lamilia{at}ospedale.lecco.it



  Abstract

Background. Patients on peritoneal dialysis (PD) with high small solute peritoneal membrane transport have an increased risk of morbidity and mortality. The membrane transport is currently assessed by peritoneal equilibration test (PET), usually performed after the first month of PD because of the early increase of membrane transport after the start of PD. The aim of this study was the assessment of small solute peritoneal membrane transport before and after the start of PD.

Methods. The small solute peritoneal membrane transport was evaluated in 34 patients before the start of PD. Twenty-two patients were treated with continuous ambulatory peritoneal dialysis (CAPD) and 12 with automated peritoneal dialysis (APD).

Results. Four months after the start of PD, the small solute peritoneal membrane transport increased only in CAPD patients (D/PCreat, the ratio between dialysate solute concentration at the end of the PET and creatinine plasma concentration, changed from 0.66 ± 0.12 to 0.73 ± 0.07 in CAPD patients and from 0.64 ± 0.12 to 0.61 ± 0.07 in APD patients), and after about 16 months of PD, the peritoneal membrane transport was higher in CAPD patients (D/PCreat = 0.74 ± 0.06) than in APD patients (D/PCreat = 0.63 ± 0.10).

Conclusions. Performing the PET before and after the start of PD could provide relevant information about the characteristics of small solute peritoneal membrane transport and could be useful to evaluate the influence of PD modality on the changes in peritoneal membrane transport.

Keywords: automated peritoneal dialysis (APD); continuous ambulatory peritoneal dialysis (CAPD); peritoneal equilibration test (PET); peritoneal membrane transport

Received for publication: 17.10.08
Accepted in revised form: 13. 3.09


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