Double mini peritoneal equilibration test equilibration test (mini-PET) in evaluation of peritoneal membrane function and its determinants

Introduction: the function of the peritoneal membrane can deteriorate over time. Peritonitis and glucose overload may be the important reasons. Contemporary functional tests are able to evaluate the fluid transport characteristics. Its alteration can predict submesotelial fibrosis progression. Methods: the cross-sectional study in 46 unselected patients from one center (female - 54%, age 59±16) with PD vintage of 35±34 months is the start of prospective observational study. The peritoneal membrane function was assessed with double mini-PET (two 1-hour exchange with 4.25% and 1.5% glucose). The glucose load was evaluated as the total mass of glucose flooded in cavity according PD-regimen per month and totally. Results: the total ultrafiltration was 562±199 ml including free water transport (FWT) - 171±68 ml and water transport through small pores 391±161 ml. The osmotic conductance to glucose (OCG) was 5.38±2.88 μl/min/mmHg. The longer PD time was linked with lower FWT (-16 ml/year) and OCG (-0.233 μl/min/mmHg/year) and with higher MTAC-Cr (+1.2 ml/min/year). FWT was inversely linked with the total glucose load, but for monthly load such association was significant only for subgroups without history of peritonitis or with monthly load higher than median (2.72 kg/mo). In multivariate regression models FWT was predicted by total glucose load (-4.8 mL/[10 kg], p=0,002) (but not monthly load) for whole group. In the subgroup with monthly load higher than median the dialysis duration (but not total glucose load) was inversely linked with FWT (-24 ml/1 year). Conclusion: the discrepancy in fluid and solute transport parameters under impact of different factors require more longitudinal studies to improve the prognosis evaluation for UFF and submesothelial fibrosis.

перитонеальная мембрана, мини-PET, транспорт свободной воды, несостоятельность ультрафильтрации, перитонеальный диализ, peritoneal membrane, mini-PET, free water transport, ultrafiltration failure, peritoneal dialysis

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