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Real-Time, Semi-Automated Fluorescent Measurement of the Airway Surface Liquid pH of Primary Human Airway Epithelial Cells
Published on: June 13, 2019
No significant differences in peritoneal fluid handling in children using PH-neutral or acidic solutions
Peter Nourse1, Nicole C A J van de Kar, Hans L Willems
1Department of Pediatric Nephrology, University Medical Center, Utrecht, The Netherlands. nourse@sun.ac.za
Summary
Switching pediatric patients to pH-neutral dialysis solutions does not significantly alter peritoneal fluid kinetics. This study found no significant differences in fluid handling or solute clearance between pH-neutral and conventional acidic solutions, suggesting safety for pediatric peritoneal dialysis.
Area of Science:
- Pediatric Nephrology
- Dialysis Therapy
- Peritoneal Physiology
Background:
- Conventional acidic peritoneal dialysis (PD) solutions may negatively impact peritoneal mesothelial cells and microcirculation.
- Potential toxic effects necessitate investigating alternative PD fluid formulations for pediatric patients.
Purpose of the Study:
- To investigate peritoneal fluid kinetics in children using pH-neutral dialysis solutions compared to conventional acidic solutions.
- To assess the impact of pH-neutral solutions on transcapillary ultrafiltration and solute clearance in pediatric PD.
Main Methods:
- Peritoneal equilibration tests (PETs) were conducted in 12 pediatric PD patients using a pH-neutral solution (Physioneal).
- Results were compared to a historical cohort of 12 pediatric patients on acidic PD solutions.
- Key outcome measures included transcapillary ultrafiltration (TCUF) and marker clearance (urea, creatinine, glucose).
Main Results:
- No significant differences were observed in transcapillary ultrafiltration (TCUF) or lymphatic absorption between the two groups.
- Small solute clearance, measured by dialysate-to-plasma ratios for urea and creatinine and glucose D(t)/D(0) ratio, remained comparable.
- The hypothetical alteration in TCUF with acidic solutions was not established.
Conclusions:
- Peritoneal fluid kinetics are not significantly altered when switching pediatric patients from acidic to pH-neutral dialysis solutions.
- pH-neutral solutions appear to be a safe alternative regarding fluid handling and solute transport in pediatric PD.
- Further research may explore long-term outcomes and specific patient populations.
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