PHYSIOLOGICAL PROPERTIES OF THE PERITONEUM IN AN ADULT PERITONEAL DIALYSIS POPULATION OVER A THREE-YEAR PERIOD

• Published in: Peritoneal dialysis international 2006-07, Vol.26 (4), p.482-489
• Main Authors: Johansson, Ann-Cathrine, Haraldsson, Borje
• Format: Article
• Language: English
• Subjects: Adult; Comorbidity; Female; Humans; Intestinal Absorption; Kidney Diseases - classification; Kidney Diseases - physiopathology; Kidney Diseases - therapy; Kidney Failure, Chronic - physiopathology; Kidney Failure, Chronic - therapy; Kinetics; Male; Middle Aged; Peritoneal Cavity - physiology; Peritoneal Dialysis - trends; Peritoneum - anatomy & histology; Peritoneum - physiopathology; Urologi och njurmedicin; Urology and Nephrology
• ISSN: 0896-8608; 1718-4304
• DOI: 10.1177/089686080602600413

Department of Nephrology 1 and Department of Physiology, 2 Sahlgrenska University Hospital, Gothenburg, Sweden Correspondence to: A.-C. Johansson, Department of Nephrology and Transplantation, University Hospital of Malmö, SE-205 02 Malmö, Sweden. Ann-Cathrine.Johansson{at}skane.se Objectives: To describe the physiological properties of the peritoneal membrane in adult patients treated with peritoneal dialysis (PD) and to analyze the effects of patient characteristics and time. Design: Observational study. Setting: Department of Nephrology at the Sahlgrenska University Hospital. Method: Peritoneal function was analyzed by the Personal Dialysis Capacity (PDC) test, based on the three-pore theory of capillary transport. The functional PDC variables are absorption, large-pore flow, and the area parameter (A 0 / x ), which determines the diffusion of small solutes. The ultrafiltration (UF) coefficient is determined mainly by A 0 / x . Patients: All patients ( n = 280) who had at least one PDC test done between September 1990 and August 1999. Results: In 249 patients examined soon after start of PD, area was 19000 (SD 7100) cm 2 /cm/1.73 m 2 , large-pore flow 0.112 (SD 0.052) mL/min/1.73 m 2 , and the UF coefficient 0.071 (SD 0.032) mL/minute/mmHg/1.73 m 2 . Absorption was 1.54 (SD +2.64, –0.97) mL/min/1.73 m 2 . Large-pore flow was greater in patients with severe comorbidity than in patients with fewer comorbid conditions. Elderly patients had a lower UF coefficient than did younger patients ( p < 0.05). Repeated PDC tests were performed in 208 patients during a mean observation time of 18.4 months. There was a slight increase in the slope of the area-versus-time curve of 54 cm 2 /cm/1.73 m 2 per month (approximately 10% after 3 years, p < 0.01); all other parameters remained constant. Conclusion: Patient characteristics have an impact on peritoneal performance already at the start of dialysis. Peritoneal function can remain essentially stable during medium long-term PD. KEY WORDS: Peritoneal physiology; Personal Dialysis Capacity (PDC). Received 14 June 2005; accepted 7 December 2005.