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Evaluation of intraperitoneal pressure and the effect of different osmotic agents on intraperitoneal pressure in

Esther Rusthoven1, Maartje E van der Vlugt, Lida J van Lingen-van Bueren

  • 1Department of Pediatric Nephrology, University Medical Center Utrecht, Utrecht, The Netherlands. erusthoven@xs4all.nl

Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis
|July 19, 2005
PubMed

Insights

Intraperitoneal pressure (IPP) was established in pediatric patients. Different dialysis solutions, like 3.86% glucose and 7.5% icodextrin, affect IPP changes differently over a 4-hour dwell period.

Area of Science:

  • Pediatric Nephrology
  • Peritoneal Dialysis
  • Intraperitoneal Pressure Dynamics

Background:

  • Establishing baseline intraperitoneal pressure (IPP) in pediatric patients is crucial for understanding peritoneal dialysis (PD) efficacy.
  • Previous studies on IPP in children are limited, necessitating larger cohort investigations.
  • The impact of different dialysate solutions on IPP requires further elucidation in pediatric populations.

Purpose of the Study:

  • To determine intraperitoneal pressure (IPP) in a substantial group of pediatric patients.
  • To investigate the effects of 3.86% glucose and 7.5% icodextrin solutions on IPP over a 4-hour dwell time.
  • To analyze the relationship between fluid kinetics and IPP changes during PD in children.

Main Methods:

  • Intraperitoneal pressure (IPP) was measured in 30 pediatric patients (median age 4.5 years).
  • Peritoneal equilibration tests (PETs) were conducted over 4 hours using 3.86% glucose and 7.5% icodextrin solutions.
  • Transcapillary ultrafiltration, net ultrafiltration, and marker clearance were calculated, with IPP recorded at 0 and 240 minutes.

Main Results:

  • Mean IPP was 12.0 +/- 6.5 cm H2O.
  • A significant correlation between changes in IPP, transcapillary ultrafiltration, and body surface area was observed with the 3.86% glucose solution.
  • No significant relations were found between these parameters during the 7.5% icodextrin PET.

Conclusions:

  • Intraperitoneal pressure (IPP) was successfully established in a large pediatric cohort, consistent with prior smaller studies.
  • Fluid kinetics significantly influence the change in IPP during a 4-hour dwell, with distinct effects observed between glucose and icodextrin solutions.
  • These findings highlight the differential impact of dialysate composition on IPP dynamics in pediatric PD patients.
Abstract

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