Categorization of sodium sieving by 2.27% and 3.86% peritoneal equilibration tests—a comparative analysis in the clinical setting

Background. Analysis of the dialysate sodium concentration during a peritoneal equilibration test (PET) provides information on the rates of water and solute transport through different membrane pathways. A hypertonic (3.86%) glucose-based dialysate may enhance the accuracy of analysis. There are st...

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Bibliographic Details
Published in:Nephrology, dialysis, transplantation dialysis, transplantation, 2009-11, Vol.24 (11), p.3513-3520
Main Authors: Gomes, Ana Marta, Fontán, Miguel Pérez, Rodríguez-Carmona, Ana, Sastre, Arancha, Cambre, Helena Díaz, Muñiz, Andrés López, Falcón, Teresa García
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Biological Transport
Emergency and intensive care: renal failure. Dialysis management
Female
Humans
Intensive care medicine
Male
Medical sciences
Middle Aged
Nephrology. Urinary tract diseases
Nephropathies. Renovascular diseases. Renal failure
Peritoneal Dialysis
peritoneal equilibration test
Peritoneum - metabolism
Prospective Studies
Renal failure
residual renal function
Sodium - metabolism
sodium sieving
Ultrafiltration
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Summary:Background. Analysis of the dialysate sodium concentration during a peritoneal equilibration test (PET) provides information on the rates of water and solute transport through different membrane pathways. A hypertonic (3.86%) glucose-based dialysate may enhance the accuracy of analysis. There are still gaps in our knowledge regarding this question, in the clinical setting. Objective. The aim of this study was to compare the categorization of the sodium sieving effect in peritoneal dialysis (PD) patients by 2.27% and 3.86% PETs, and to disclose clinical correlates of this phenomenon. Method. Ninety PD patients underwent prospectively 2.27% and 3.86% modified (dialysate samples at 0, 60, 90, 120 and 240 min) PETs, in a random order. We searched for differences in the time profiles of sodium sieving and its categorization. We correlated sodium sieving with ultrafiltration (UF) and solute transport capacity, as also with selected clinical and demographic variables, using a multivariate approach. Results. The maximum dip in the dialysate sodium concentration (11.1 mM/L, 3.86% versus 7.1 mM/L, 2.27%, P < 0.001) was most common after 90 min in the 3.86% PET, with the 2.27% test somewhere between 60 and 90 min. Low sodium sieving (defined by a dip
ISSN:0931-0509
1460-2385
DOI:10.1093/ndt/gfp319