The Influence of Initial Peritoneal Transport Characteristics, Inflammation, and High Glucose Exposure on Prognosis for Peritoneal Membrane Function

Overview

Journal Perit Dial Int

Publisher Sage Publications

Date 2012 Apr 5

PMID 22473036

Citations 7

Authors

M Jose Fernandez-Reyes

M Auxiliadora Bajo

Gloria Del Peso

Marta Ossorio

Raquel Diaz

Beatriz Carretero

Rafael Selgas

Affiliations

Soon will be listed here.

Abstract

Background: Fast transport status, acquired with time on peritoneal dialysis (PD), is a pathology induced by peritoneal exposure to bioincompatible solutions. Fast transport has important clinical consequences and should be prevented.

Objective: We analyzed the repercussions of initial peritoneal transport characteristics on the prognosis for peritoneal membrane function, and also whether the influence of peritonitis and high exposure to glucose are different according to the initial peritoneal transport characteristics or the moment when such events occur.

Methods: The study included 275 peritoneal dialysis patients with at least 2 peritoneal function studies (at baseline and 1 year). Peritoneal kinetic studies were performed at baseline and annually. Those studies consist of a 4-hour dwell with glucose (1.5% during 1981 - 1990, and 2.27% during 1991 - 2002) to calculate the peritoneal mass transfer coefficients of urea and creatinine (milliliters per minute) using a previously described mathematical model.

Results: Membrane prognosis and technique survival were independent of baseline transport characteristics. Fast transport and ultrafiltration (UF) failure are reversible conditions, provided that peritonitis and high glucose exposure are avoided during the early dialysis period. The first year on PD is a main determining factor for the membrane's future, and the mass transfer coefficient of creatinine at year 1 is the best functional predictor of future PD history. After 5 years on dialysis, permeability frequently increases, and UF decreases. Icodextrin is associated with peritoneal protection.

Conclusions: Peritoneal membrane prognosis is independent of baseline transport characteristics. Intrinsic fast transport and low UF are reversible conditions when peritonitis and high glucose exposure are avoided during the early dialysis period. Icodextrin helps in glucose avoidance and is associated with peritoneal protection.

Citing Articles

Influence of dialysate temperature on creatinine peritoneal clearance in peritoneal dialysis patients: a randomized trial.

Fontana F, Torelli C, Giovanella S, Ligabue G, Alfano G, Gerritsen K BMC Nephrol. 2020; 21(1):448.

PMID: 33109094 PMC: 7590605. DOI: 10.1186/s12882-020-02113-z.

The Association Between Glucose Exposure and the Risk of Peritonitis in Peritoneal Dialysis Patients.

van Diepen A, van Esch S, Struijk D, Krediet R Perit Dial Int. 2016; 36(5):533-9.

PMID: 27044793 PMC: 5033629. DOI: 10.3747/pdi.2014.00318.

Analysis of Ultrafiltration Failure Diagnosed at the Initiation of Peritoneal Dialysis with the Help of Peritoneal Equilibration Tests with Complete Drainage at Sixty Minutes. A Longitudinal Study.

Machado Lopes D, Rodriguez-Carmona A, Garcia Falcon T, Lopez Muniz A, Ferreiro Hermida T, Lopez Iglesias A Perit Dial Int. 2016; 36(4):442-7.

PMID: 26764342 PMC: 4934440. DOI: 10.3747/pdi.2015.00163.

The Natural Time Course of Membrane Alterations During Peritoneal Dialysis Is Partly Altered by Peritonitis.

van Esch S, Struijk D, Krediet R Perit Dial Int. 2015; 36(4):448-56.

PMID: 26526046 PMC: 4934441. DOI: 10.3747/pdi.2014.00215.

The Mutual Relationship Between Peritonitis and Peritoneal Transport.

van Esch S, van Diepen A, Struijk D, Krediet R Perit Dial Int. 2014; 36(1):33-42.

PMID: 25395498 PMC: 4737563. DOI: 10.3747/pdi.2014.00115.

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