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2016 ; 36
(4
): 442-7
Nephropedia Template TP
gab.com Text
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Twit Text #
English Wikipedia
Analysis of Ultrafiltration Failure Diagnosed at the Initiation of Peritoneal
Dialysis with the Help of Peritoneal Equilibration Tests with Complete Drainage
at Sixty Minutes A Longitudinal Study
#MMPMID26764342
Lopes DM
; Rodríguez-Carmona A
; Falcón TG
; Muñiz AL
; Hermida TF
; Iglesias AL
; Fontán MP
Perit Dial Int
2016[Jul]; 36
(4
): 442-7
PMID26764342
show ga
? BACKGROUND: Ultrafiltration failure (UFF) diagnosed at the initiation of
peritoneal dialysis (PD) has been insufficiently characterized. In particular,
few longitudinal studies have analyzed the time course of water transport in
patients with this complication. ? OBJECTIVE: To investigate the time course of
peritoneal water transport during the first year on PD in patients presenting UFF
since the initiation of this therapy (study group). ? METHOD: Prospective,
observational, single-center design. We analyzed, at baseline and after 1 year of
follow-up, peritoneal water transport in 19 patients incident on PD with UFF. We
used incident patients without UFF as a control group. Water transport was
characterized with the help of 3.86/4.25% dextrose-based peritoneal equilibration
tests (PETs) with complete drainage at 60 minutes. ? RESULTS: The study group
revealed a disorder of water transport affecting both small-pore ultrafiltration
(SPUF) (p = 0.054 vs incident without UFF) and free water transport (FWT) (p =
0.001). After 1 year of follow-up, FWT displayed a general increasing trend in
the study group (mean variation 48.9 mL, 95% confidence interval [CI] 15.5, 82.2,
p = 0.012), while the behavior of SPUF was less predictable (-4.8 mL, 95% CI
-61.4, 71.1, p = 0.85). These changes were not observed in incident patients
without UFF. Neither initial clinical characteristics, baseline PET-derived
parameters, or suffering peritoneal infections during the first year predicted
the time course of the capacity of UF in the study group. Recovery from incident
UFF was apparently linked to improvement of SPUF. ? CONCLUSIONS: Patients with
UFF at the start of PD suffer a disorder of peritoneal water transport affecting
both FWT and SPUF. Free water transport increases systematically in these
patients after 1 year of follow-up. The evolution of SPUF is less predictable,
and improvement of this parameter marks reversibility of this complication.