Andrew Davenport1, Michelle Kay Willicombe. 1. University College London Center for Nephrology, University College London Medical School, London, UK. Andrew.davenport@royalfree.nhs.uk
Abstract
BACKGROUND AND OBJECTIVES: The peritoneal equilibration test (PET) was developed some 25 yr ago and has been used to help prescribe peritoneal dialysis. However, PET is affected by several factors, including diabetes and inflammation. It was speculated that extracellular fluid overload would increase PET ultrafiltration volumes, and therefore the usefulness of the PET in routine clinical practice was audited. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Data from 211 consecutive patients attending a university teaching hospital for a standard PET who had multifrequency bioimpedance performance were analyzed to determine which factors affected net PET ultrafiltration volumes. RESULTS: Net PET ultrafiltration volume was independent of gender, age, diabetes, residual renal function, peritoneal dialysis prescriptions (modes and dialysates), extracellular fluid volume, or C-reactive protein (CRP). There was an inverse regression with serum albumin and sodium on multiple logistical regression analysis (F = 13.4, P < 0.001 and F = 10.1, P = 0.001, respectively) and a positive regression with 24-h net peritoneal ultrafiltration volumes (F = 15.5, P < 0.001). As expected, there was a strong correlation with net sodium losses (r = 0.99, P < 0001). CONCLUSIONS: It was found that PET test ultrafiltration volume in routine clinical practice was not affected by CRP, hyperglycemia, or extracellular fluid volume overload. Ultrafiltration volumes were increased in those patients with reduced serum sodium and albumin, most likely because of inflammation and protein malnutrition.
BACKGROUND AND OBJECTIVES: The peritoneal equilibration test (PET) was developed some 25 yr ago and has been used to help prescribe peritoneal dialysis. However, PET is affected by several factors, including diabetes and inflammation. It was speculated that extracellular fluid overload would increase PET ultrafiltration volumes, and therefore the usefulness of the PET in routine clinical practice was audited. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Data from 211 consecutive patients attending a university teaching hospital for a standard PET who had multifrequency bioimpedance performance were analyzed to determine which factors affected net PET ultrafiltration volumes. RESULTS: Net PET ultrafiltration volume was independent of gender, age, diabetes, residual renal function, peritoneal dialysis prescriptions (modes and dialysates), extracellular fluid volume, or C-reactive protein (CRP). There was an inverse regression with serum albumin and sodium on multiple logistical regression analysis (F = 13.4, P < 0.001 and F = 10.1, P = 0.001, respectively) and a positive regression with 24-h net peritoneal ultrafiltration volumes (F = 15.5, P < 0.001). As expected, there was a strong correlation with net sodium losses (r = 0.99, P < 0001). CONCLUSIONS: It was found that PET test ultrafiltration volume in routine clinical practice was not affected by CRP, hyperglycemia, or extracellular fluid volume overload. Ultrafiltration volumes were increased in those patients with reduced serum sodium and albumin, most likely because of inflammation and protein malnutrition.
Authors: Jos van de Kerkhof; Marc Hermans; Charles Beerenhout; Constantijn Konings; Frank M van der Sande; Jeroen P Kooman Journal: Blood Purif Date: 2004 Impact factor: 2.614
Authors: Simon J Davies; Graham Woodrow; Kieron Donovan; Jörg Plum; Paul Williams; Ann Catherine Johansson; Hans-Peter Bosselmann; Olof Heimbürger; Ole Simonsen; Andrew Davenport; Anders Tranaeus; Jose C Divino Filho Journal: J Am Soc Nephrol Date: 2003-09 Impact factor: 10.121
Authors: Andrew Davenport; Banwari Argawal; Gavin Wright; Konstantinos Mantzoukis; Rumyana Dimitrova; Joseph Davar; Panayota Vasianopoulou; Andrew K Burroughs Journal: World J Hepatol Date: 2013-08-27