Abstract: TH-PO871
Peritoneal Membrane Transport Characteristics in Uni-Peritoneal Equilibration Test (PET) with Preceding Icodextrin Dwell as Compared to Classic PET with Preceding Glucose Dwell: A Pilot Study
Session Information
- Peritoneal Dialysis - I
November 02, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Dialysis
- 608 Peritoneal Dialysis
Authors
- Kohli, Harbir Singh, Post Graduate Institute of Medical Education and Research (PGIMER), CHANDIGARH, Haryana, India
- Vohra, Gaurav, Post Graduate Institute of Medical Education and Research (PGIMER), CHANDIGARH, Haryana, India
- Kumar, Vivek, Postgraduate Institute of Medical Education and Research, Chandigarh, India
- Gupta, Krishan Lal L., Postgraduate Institute of Medical Education & Research, Chandigarh, India
Background
In subjects on CAPD who use icodextrin for long night dwell, it has been recommended that nocturnal icodextrin exchange be replaced by dextrose dwell whenever PET is to be performed. This is because it has been thought that preceding exchange with icodextrin temporarily increases peritoneal membrane permeability and therefore, gives high dialysate/plasma creatinine (D/P cr) and low dialysate glucose at end of PET/dialyste glucose in fresh solution (D/D0) value. Whether this temporary change is also seen with use of Uni-PET (which involves one hour dwell of 1.5% dextrose followed by 4-hour dwell of 4.25% dextrose) is not known.
Methods
In this self, controlled study, subjects on CAPD, who were using icodextrin for long nocturnal dwell for at least 3 months, were screened for enrolment. Pregnancy or lactation, history of any PD related infectious complication in the past one month, present or past malignancy, and poor functional status were exclusion criteria. On day 1 enrolled subjects underwent classic PET with preceding 2.5% dextrose long nocturnal dwell and on day 2 Uni-PET was done with preceding 7.5% icodextrin long nocturnal dwell. Difference in D/P cr and D/D0 glucose between the two PETs were primary objectives. The study was approved by Institute Ethics Committee.
Results
Of 26 screened subjects 15 were enrolled over a period of 18 months (July 2015-December 2016). The mean (±SD) age of study population was 60.8±9.1 years. Majority were males and diabetes was the most common cause of CKD. Mean D/P cr were 0.68 ± 0.11 and 0.64 ± 0.08 in classic PET and Uni-PET, respectively. The difference between the two values was not significant [mean difference between D/P cr (classic PET-Uni-PET): 0.040 ± 0.86; 95% CI (-0.007 to 0.088); p=0.09]. Similarly, D/D0 glucose between classic PET and Uni-PET were also similar [mean difference between D/D0 glucose (classic PET-Uni-PET): -0.02 ± 0.09; 95% CI (-0.06 to 0.03); p = 0.448].
Conclusion
Peritoneal membrane small solute transport characteristics in Uni-PET with preceding icodextrin dwell are similar to classic PET with preceding glucose dwell. If Uni-PET is used, it is not necessary to replace preceding nocturnal exchange of icodextrin with that of dextrose