Standard peritoneal permeability analysis in children

• Published in: Journal of the American Society of Nephrology 2000-05, Vol.11 (5), p.943-950
• Main Authors: BOUTS, A. H. M, DAVIN, J.-C, GROOTHOFF, J. W, VAN AMSTEL, S. P, ZWEERS, M. M, KREDIET, R. T
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Albumins - metabolism; alpha-Macroglobulins - metabolism; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; beta 2-Microglobulin - metabolism; Biological and medical sciences; Biological Transport; Child; Child, Preschool; Creatinine - metabolism; Cross-Sectional Studies; Emergency and intensive care: renal failure. Dialysis management; Female; Humans; Intensive care medicine; Macromolecular Substances; Male; Medical sciences; Molecular Weight; Monitoring, Physiologic - standards; Peritoneal Dialysis; Peritoneum - metabolism; Permeability; Reference Values; Statistics, Nonparametric; Urea - metabolism
• ISSN: 1046-6673
• DOI: 10.1681/asn.v115943

Peritoneal transport characteristics in children on peritoneal dialysis (PD) has been reported to be different compared to adults. However, various test methods can influence this difference. Thirty-one standard peritoneal permeability analyses (SPA) were performed in 18 PD children with a median (range) age of 9.8 yr (2 to 19) and a median duration of PD of 2.6 yr (0.19 to 6.8). The median mass transfer area coefficient (MTAC) for creatinine was 9.6 ml/min per 1.73 m(2) (4.4 to 18.0), and for urea 17.3 ml/min per 1. 73 m(2) (12.2 to 22.8). The median dialysate to plasma creatinine ratio (D/P(Cr)) was 0.69 (0.44 to 0.92), the glucose absorption 59% (23 to 75), and the D/D(0) for glucose 0.38 (0.23 to 0.62). The median clearance of beta(2)-microglobulin was 923 microl/min per 1. 73 m(2) (366 to 1828), of albumin 103 microl/min per 1.73 m(2) (55 to 211), of IgG 48 microl/min per 1.73 m(2) (20 to 105), and of alpha(2)-macroglobulin 12 microl/min per 1.73 m(2) (5 to 49). No correlation was found between these results and age or PD time. The restriction coefficient for macromolecules indeed increased with duration of PD treatment (r = 0.38, P = 0.03). The median transcapillary ultrafiltration rate was 1.2 ml/min per 1.73 m(2) (-0. 01 to 2.8), the net ultrafiltration rate 0.2 ml/min per 1.73 m(2) (-1.97 to 1.82), and the effective lymphatic absorption rate 1.04 ml/min per 1.73 m(2) (-0.06 to 2.91). When corrected for body surface area, no differences were found in peritoneal fluid and solute transport characteristics between children and adults. No effect of time on PD on the transport parameters was found in a cross-sectional analysis, except for an increase of the restriction coefficient to macromolecules. This finding is similar to observations in adults. Therefore, the present study showed no evidence for the common belief that the peritoneal membrane in children is different from that in adult patients.