Reference Range of Values of Peritoneal Equilibration Test and Changes in Peritoneal Kinetics in Korean Long-Term CAPD Patients

Park, Joo Hyun; Koh, Seung Hyun; Kim, Byung Soo; Yang, Chul Woo; Kim, Yong Soo; Kim, Suk Young; Choi, Euy Jin; Chang, Yoon Sik; Bang, Byung Kee

Abstract

PURPOSE: The aim of this study was to define the reference range of the peritoneal solute transfer in Korean CAPD patients and to investigate the change in peritoneal kinetics in long-term patients.
METHODS
Routine PET was done 14 days after catheter break-in in 102 new CAPD patients and using our reference range of PET, the patients were categorized into 4 groups as described by Twardow- ski. In 35 long-term (>3 yrs) CAPD patients, D/Pcr, D/D0 glucose and drain volume in last follow- up (mean duration, 60+/-23 months) PET were compared with those in initial PET.
RESULTS
Dialysate to Plasma creatinine ratio (D/ Pcr) at 0 hour, 2 hours and 4 hours was 0.045+/-0.062, 0.408+/-0.151 and 0.612+/-0.154, respectively. D/D0 glucose at 2 hours and 4 hours was 0.594+/-0.129 and 0.398+/-0.121, respectively. Peritoneal solute transfer rate in Korean patients was slightly lower than previously reported results in North American patients (P=0.08). Mean drain volume was 2360+/-270ml and mean residual volume was 436+/-178ml. Drain volume was well correlated with D/D0 glucose (positively, r=0.375, P<0.01) and D/Pcr (negatively, r=-0.345, P<0.01). There were no difference in peritoneal solute transfer, drain volume and residual volume according to sex, age, body surface area and diabetes. In initially high and high average trans- porters, solute transfer rate decreased significantly in followup PET. Out of 7 initially high transporters, 3 remained in high and 4 became high average transporters. Out of 12 initially high average transporters, 3 became low average transporters. Out of 8 initially low average transporters, 2 became high average transporters. And out of 8 initially low transporters, 2 became high average and 1 became high transporters. The number of episodes of perito- nitis do not significantly correlated with the changes of peritoneal solute transport rate.
CONCLUSION
These data suggest that peritoneal solute transfer rate in Korean patients is slighthly lower compared with that in North American patients and in long-term CAPD patients the peri- toneal solute transport rate changed to centropetal directions (towards to mean) according to initial PET result.