Lack of correlation between baseline peritoneal membrane status and pre-dialytic characteristics

The determinants of peritoneal transport status in incident peritoneal dialysis (PD) patients are not well defined. Comorbidity, inflammation status, race, age, and mesothelial cell mass are some factors correlated with the baseline dialysate-to-plasma ratio of creatinine. Our aim was to define factors in the pre-dialysis period that possibly correlate with baseline peritoneal transport characteristics. Our study included patients starting PD at our center over the last 7 years. These patients should have been followed in our department for at least 1 year before PD start. Demographic and laboratory data were collected at 12 and 6 months before PD start. Protein intake was calculated from 24-hour urine collections. The Davies comorbidity index was scored for the pre-dialytic period. A baseline standard peritoneal permeability analysis was performed within the 6 first months of PD therapy. The mass transfer area coefficients (MTACs) for creatinine and urea were calculated. Of 94 consecutive PD patients, 47 patients (age: 50.7 +/- 15.2 years) met the inclusion criteria. Mean monthly pre-dialytic decline in the glomerular filtration rate (GFR) was 0.27 +/- 0.17 mL/min per 1.73 m2 body surface area, and daily protein intake was 0.77 +/- 0.19 g/kg. Baseline MTACs of creatinine and urea were 12 +/- 3.6 mL/min and 19.6 +/- 5.3 mL/min respectively. No correlation was found between MTAC and any of age, Davies index, protein intake, lipid levels, C-reactive protein, or monthly GFR decline. In our population, we observed no pre-dialytic factor interfering with baseline peritoneal status.