NDT Advance Access published online on April 6, 2004
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfh223
© 2004 by European Renal Association - European Dialysis and Transplant Association
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1 Department of Nephrology and Dialysis, A. Manzoni Hospital, Lecco, Italy
* To whom correspondence should be addressed. E-mail: v.lamilia{at}ospedale.lecco.it.
Background. Sodium removal (NaR) may have a major impact on the survival of peritoneal dialysis patients. The dialysate/plasma sodium concentration ratio (D/PNa) is an indirect index of transcellular water transport by aquaporin channels, and thus of ultrafiltration. Sodium concentration can be assessed by means of flame photometry (F), and direct (D-ISE) or indirect ion-selective electrodes (I-ISE), but these methods have different properties. I-ISE is being used increasingly in clinical laboratories. The aim of this study was to evaluate NaR and D/PNa using the three different measurement methods. Methods. We performed peritoneal equilibration tests (PETs) in 44 peritoneal dialysis patients and calculated the NaR. We also calculated D/PNa during the test; plasma and dialysate sodium concentrations were measured by F, D-ISE and I-ISE. Results. NaR was lower (P<0.001) with D-ISE (69±29 mmol) than with F (81±29 mmol) or I-ISE (79±28 mmol). D/PNa was also lower at baseline (0.92±0.02 vs 0.95±0.02 and 0.95±0.02; P<0.001), after 60 min (0.87±0.03 vs 0.90±0.03 and 0.90±0.03; P<0.001) and at the end of PET (0.88±0.04 vs 0.92±0.04 and 0.92±0.04; P<0.001) when measured by D-ISE in comparison with F and I-ISE, respectively. Conclusions. NaR and D/PNa were lower when measured by the D-ISE method compared with the F and I-ISE methods. NaR and D/PNa were similar when measured by F or I-ISE. I-ISE can be used reliably in the evaluation of NaR and D/PNa in everyday clinical practice of peritoneal dialysis.
Accepted February 18, 2004
Original Article
Sodium removal and sodium concentration during peritoneal dialysis: effects of three methods of sodium measurement
2 Provincial Hospital, Camposampiero, Italy
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