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Changes in peritoneal equilibration test values during long-term peritoneal dialysis in peritonitis-free children
1Department of Pediatrics, Dokkyo University School of Medicine, Koshigaya Hospital, Saitama, Japan. a-yoshino@sam.hi-ho.ne.jp
Insights
Peritoneal equilibration test (PET) values in children on peritoneal dialysis (PD) show gradual changes after 24 months. D/P creatinine increases and D/D0 glucose decreases, suggesting 24-month PET values as a standard for long-term PD in pediatric patients.
Area of Science:
- Pediatric Nephrology
- Renal Physiology
- Dialysis Medicine
Background:
- Peritoneal dialysis (PD) is a crucial treatment for children with end-stage renal disease.
- Long-term changes in peritoneal equilibration test (PET) parameters in pediatric PD patients are not well-documented.
- Understanding these changes is vital for optimizing PD therapy and patient outcomes.
Purpose of the Study:
- To investigate the longitudinal changes in peritoneal equilibration test (PET) values in children undergoing long-term peritoneal dialysis (PD).
- To establish reference PET values for children after a significant duration of PD therapy.
Main Methods:
- A prospective study involving 39 children (mean age 8.8 years) on PD.
- Peritoneal equilibration tests (PET) were conducted every 6 months for up to 85 months.
- Measurements included D/P creatinine and D/D0 glucose ratios, excluding patients with peritonitis.
Main Results:
- No significant changes in D/P creatinine or D/D0 glucose were observed during the initial 24 months of PD.
- After 24 months, a gradual increase in D/P creatinine (from 0.66 to 0.70, p=0.0051) and a decrease in D/D0 glucose (from 0.42 to 0.38, p=0.0015) were noted.
- The most substantial alterations in PET parameters occurred beyond the 24-month mark.
Conclusions:
- Peritoneal equilibration test (PET) values in children on PD demonstrate significant changes after 24 months of treatment.
- The study suggests that mean PET values at 24 months can be considered standard reference values for long-term PD in pediatric populations.
- These findings aid in monitoring PD adequacy and tailoring treatment strategies for children on long-term PD.
Abstract:
Little is known about the changes in peritoneal equilibration test (PET) values in children on long-term peritoneal dialysis (PD). In the present study, a PET was carried out every 6 months in 39 children (mean age 8.8 +/- 5.5 years) undergoing PD for 6 to 85 months (mean 36.9 +/- 23.1 months). Patients experiencing peritonitis were excluded. Both D/P creatinine (dialysate-to-plasma ratio of creatinine at 4 hours) and D/D0 glucose (ratio of dialysate glucose at 4 hours' dwell time to dialysis glucose at 0 dwell time) were measured 195 times in this series of patients. No remarkable change was found for D/P creatinine or D/D0 glucose during the first 24 months of PD but thereafter, D/P creatinine increased gradually and D/D0 glucose decreased gradually. Mean D/P creatinine increased significantly after the first 24 months of PD: from 0.66 +/- 0.12 during the first 24 months, to 0.70 +/- 0.09 after 25 months and more of PD (p = 0.0051). Mean D/D0 glucose decreased significantly after 24 months of PD: from 0.42 +/- 0.09 during the first 24 months, to 0.38 +/- 0.08 after 25 months and more of PD (p = 0.0015). The most significant change for both D/P creatinine and D/D0 glucose occurred after 24 months of PD. It seems reasonable to consider the mean PET values at 24 months of PD as the standard PET values.