[Determination of peritoneal permeability in chronic peritoneal dialysis using the peritoneal equilibration test].

BACKGROUND

The success of chronic peritoneal dialysis depends among others on the extent of its function as a semipermeable membrane. This so-called functional characteristic can be assessed by several procedures, e.g. by using the so-called peritoneal equilibration test. The objective of the author's investigation was to assemble experience with the method, and based on the results, elaborate an individual therapeutic plan.

METHODS AND RESULTS

In 17 patients (8 men, 9 women, mean age when chronic peritoneal dialysis was started 58.4 +/- 11.8 years) the functional capacity of the peritoneum was evaluated using the peritoneal equilibration test (PET). The principle of the test is assessment of the D/P ratio for creatinine and D/Do for glucose (D = concentration of the substance in the dialysate, p = blood concentration of the substance, Do = glucose concentration in the dialysis solution at the time of onset of the test) during four-hour dialysis with 2000 ml solution with a glucose concentration of 2.27% (127 mmol/l). The standardized procedure of the peritoneal equilibration test (12) was modified as regards the calculation of the D/Do ratio: this change simplifies the manipulation with the outlet dialysate and does not affect the result of the test. A total of 22 examinations were made. Based on the results, four patients were included in category H (high peritoneal permeability), 11 into category HA (high average peritoneal permeability) and 2 into category LA (low average permeability). The patients with a higher peritoneal permeability had a lower serum protein concentration (r = -0.63, p < 0.001), and the proteinaemia correlated indirectly with protein losses into the dialysate (r = -0.54, p < 0.01). Intermittent treatment which was prescribed to patients with a high average peritoneal permeability could reduce the total protein losses into the dialysate.

CONCLUSIONS

The peritoneal equilibration test is an available method which makes it possible to evaluate the functional properties of the peritoneum.