Comparative Assessment of Peritoneal Membrane Characteristics in Patients on Continuous Ambulatory Peritoneal Dialysis Using Standard Peritoneal Equilibration Test and Fast Peritoneal Equilibration Test

• Main Authors: Aman Gupta, Pradeep Deshpande, G Sridhar, J Ramashankar
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2021-01-01
• Series: Indian Journal of Nephrology
• Subjects: d/p creatinine ratio; permeability category; solute (creatinine) transfer; transporter type
• Online Access: http://www.indianjnephrol.org/article.asp?issn=0971-4065;year=2021;volume=31;issue=2;spage=130;epage=134;aulast=Gupta

Background: Evaluation of peritoneal membrane permeability in patients on continuous ambulatory peritoneal dialysis (CAPD) is crucial in prescribing treatment regimens. This study evaluated peritoneal membrane characteristics in patients on CAPD using standard peritoneal equilibration test (PET) and fast PET. Methods: A prospective observational longitudinal study included patients on CAPD with no symptoms of peritonitis for at least 4 weeks before the PET. Both, standard and fast PET were performed using 2.5% glucose-containing dialysate. The dialysate and plasma (D/P) creatinine ratios at each time point (i.e., 0 h, 2nd h, and 4th h) in standard and at 4th hour only in fast PET were determined. Patients were classified according to D/P creatinine value as high, high-average, low-average, low transporter. The follow-up period was 6 months and changes in membrane characteristics were compared again to revalidate the efficacy of fast PET. Results: A total of 50 patients between 41 and 70 years of age were enrolled. The majority had diabetic nephropathy (40%) and chronic glomerulonephritis (28%). Based on transport type, a significant positive correlation was observed between the D/P creatinine ratio of baseline standard PET I and fast PET I (r = 0.992, P ≤ 0.05) and standard PET II and fast PET II (r = 0.969, P ≤ 0.05) done after 6 months. The results of the PET and transport category after 6 months were similar in 82% cases determined by fast PET and 98% cases determined by the standard pet. There was significant agreement between both the methods of PET (K value = 0.872, P < 0.001). A significant (P ≤ 0.001) correlation was observed between standard PET I and standard PET II transport status. Conclusion: Fast PET is a good alternative for assessing peritoneal membrane characteristics especially in the setting of less availability of resources and is a less cumbersome procedure as compared to standard PET.