M V Rocco1, J R Jordan, J M Burkart. 1. Department of Internal Medicine, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA.
Abstract
OBJECTIVE: To determine the ability of the dialysis adequacy and transport test (DATT) to monitor changes in peritoneal transport characteristics over time. SETTING: University-based peritoneal dialysis program. PATIENTS: One hundred patients on continuous ambulatory peritoneal dialysis who underwent 226 simultaneous DATTs and peritoneal equilibration tests (PET). METHODS: Retrospective analysis of DATT and PET data. RESULTS: The mean 24-hour dialysate-to-plasma creatinine (cr) concentration ratio (D/P cr) from the DATT was 0.70 +/- 0.10, and the mean four-hour D/P cr from the PET was 0.68 +/- 0.10. The correlation coefficient between the four-hour and 24-hour D/P cr was 0.81, and the standard error of estimate was 0.065. The mean (+/- SD) difference between the four-hour and 24-hour D/P cr was 0.023 +/- 0.061. Fifty-eight patients had two or more sequential DATTs and PETs. For these 94 sets of sequential DATTs and PETs, the mean (+/- SD) difference between the change in the four-hour D/P cr and the change in the 24-hour D/P cr was 0.020 +/- 0.024, and the standard error of estimate was 0.064. In 17 patients a change in dwell volume from 2.0 L to 2.5 L occurred between the first and second measures of peritoneal membrane transport characteristics. The mean (+/- SD) difference between the change in the four-hour D/P cr and the change in the 24-hour D/P cr was 0.036 +/- 0.055, and the standard error of estimate was 0.087. CONCLUSION: The DATT can be used to monitor for changes in peritoneal transport over time. It should not be used in patients receiving cycler therapy or in patients whose dwell times and dextrose concentrations vary markedly from day to day.
OBJECTIVE: To determine the ability of the dialysis adequacy and transport test (DATT) to monitor changes in peritoneal transport characteristics over time. SETTING: University-based peritoneal dialysis program. PATIENTS: One hundred patients on continuous ambulatory peritoneal dialysis who underwent 226 simultaneous DATTs and peritoneal equilibration tests (PET). METHODS: Retrospective analysis of DATT and PET data. RESULTS: The mean 24-hour dialysate-to-plasma creatinine (cr) concentration ratio (D/P cr) from the DATT was 0.70 +/- 0.10, and the mean four-hour D/P cr from the PET was 0.68 +/- 0.10. The correlation coefficient between the four-hour and 24-hour D/P cr was 0.81, and the standard error of estimate was 0.065. The mean (+/- SD) difference between the four-hour and 24-hour D/P cr was 0.023 +/- 0.061. Fifty-eight patients had two or more sequential DATTs and PETs. For these 94 sets of sequential DATTs and PETs, the mean (+/- SD) difference between the change in the four-hour D/P cr and the change in the 24-hour D/P cr was 0.020 +/- 0.024, and the standard error of estimate was 0.064. In 17 patients a change in dwell volume from 2.0 L to 2.5 L occurred between the first and second measures of peritoneal membrane transport characteristics. The mean (+/- SD) difference between the change in the four-hour D/P cr and the change in the 24-hour D/P cr was 0.036 +/- 0.055, and the standard error of estimate was 0.087. CONCLUSION: The DATT can be used to monitor for changes in peritoneal transport over time. It should not be used in patients receiving cycler therapy or in patients whose dwell times and dextrose concentrations vary markedly from day to day.