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Comparison of a 2.5% and a 4.25% dextrose peritoneal equilibration test
Eric T Pride1, Joan Gustafson, Angie Graham
1Department of Internal Medicine, Wake Forest University School of Medicine, and Piedmont Dialysis Center, Inc, Winston-Salem, North Carolina 27157-1053, USA.
Background:
Ultrafiltration (UF) failure develops over time in some patients on peritoneal dialysis. The workup of UF failure can be difficult and the 4.25% peritoneal equilibration test (PET) has been suggested to be more useful than the 2.5% PET for the workup of UF failure. It is unknown how a 4.25% PET compares to a 2.5% PET in individual patients.
Objectives:
To assess the differences in drain volumes and sodium sieving using a 4.25% PET compared to a 2.5% PET, and to determine whether peritoneal transport rates, in terms of dialysate-to-plasma (D/P) ratios, are comparable between the two.
Design:
Pilot study with each patient serving as his or her own control.
Setting:
Outpatient dialysis facility of Wake Forest University Baptist Medical Center.
Patients:
47 patients, all of whom had a 2.5% PET and a 4.25% PET performed within 1 week of each other.
Outcome Measures:
Dialysate-to-plasma ratios of urea and creatinine, dialysate total protein, and dialysate glucose compared to time zero (D/D0) at 0, 2, and 4 hours. Four-hour drain volumes and sodium sieving at 2 hours were also measured.
Results:
There was reproducibility between the 2.5% and 4.25% PET for D/P ratios of urea and creatinine and for dialysate total protein. There were expected differences in drain volume, sodium sieving, and D/D0 glucose between the two methods.
Conclusions:
The use of a 4.25% PET may be more useful for the workup of UF failure because of the accentuation of drain volume and sodium sieving, while remaining useful for prescription management.