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Longitudinal changes in peritoneal equilibration test with or without peritonitis in children
1Department of Paediatrics and Child Health, Kurume University School of Medicine, Japan.
Insights
Peritonitis significantly impacts peritoneal dialysis in children. Repeated peritoneal equilibration tests show decreased creatinine transport after peritonitis episodes, affecting long-term dialysis effectiveness.
Area of Science:
- Pediatric Nephrology
- Renal Replacement Therapy
Background:
- Continuous peritoneal dialysis (CPD) is a key treatment for pediatric kidney failure.
- Peritoneal equilibration test (PET) assesses peritoneal membrane function during dialysis.
- Understanding longitudinal changes in PET is crucial for optimizing pediatric CPD therapy.
Purpose of the Study:
- To evaluate longitudinal changes in the peritoneal equilibration test (PET) in children undergoing continuous peritoneal dialysis (CPD).
- To investigate the impact of prolonged CPD and peritonitis episodes on PET parameters.
Main Methods:
- PET was performed up to five times in 12 pediatric patients over a mean interval of 22.8 months.
- Patients were divided into groups with and without peritonitis.
- Dialysate/plasma (D/P) creatinine and dialysate/initial dialysate (D/Do) glucose ratios were analyzed.
Main Results:
- In the peritonitis group (n=6), the 4-h D/P creatinine ratio decreased progressively over time.
- The final D/P creatinine ratio was significantly lower than the initial PET in the peritonitis group (P < 0.01).
- No significant changes in D/P creatinine or D/Do glucose ratios were observed in the non-peritonitis group (n=6).
Conclusions:
- Prolonged CPD itself does not affect creatinine membrane permeability.
- Peritonitis episodes lead to a decrease in peritoneal membrane permeability for creatinine over time.
- PET is a valuable tool for monitoring sequential changes in peritoneal function in pediatric CPD patients.
Abstract:
This study was conducted to evaluate longitudinal changes in the peritoneal equilibration test (PET) in children treated with continuous peritoneal dialysis (CPD). The effects of prolonged CPD and episodes of peritonitis on the PET were examined. PET was repeated up to five times in 12 paediatric patients who were subdivided into groups with and without peritonitis. In the peritonitis group (n = 6), the dialysate/plasma (D/P) creatinine ratio at a 4-h dwell time decreased progressively with time on CPD in five of six patients. In a comparison of the initial and final PETs performed at a mean interval of 22.8 +/- 11.6 months, the D/P creatinine ratio in the final PET was significantly lower than in the initial PET (P < 0.01). In contrast, in the non-peritonitis group (n = 6), the D/P creatinine ratio in the final PET was unchanged for 28.2 +/- 12.3 months from the initial PET. The D/Do glucose ratio at a 4-h dwell time was unchanged over time in each group. Thus, repeated PET measurements revealed that membrane permeability for creatinine was not affected by prolonged CPD itself, but decreased with time after episodes of peritonitis. Although the protocol for PET is not standardised in children, PET was useful for determining the sequential changes in peritoneal function in such patients on CPD.