Longitudinal follow-up of Free Water Transport, D/P Cr and Effluent Ca125 in patients on Peritoneal Dialysis

2017 ◽  
Author(s):  
Miguel Oliveira
Keyword(s):  
Peritoneal Dialysis ◽  
Water Transport ◽  
Free Water

scholarly journals 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

2016 ◽  
Vol 36 (4) ◽  
pp. 442-447 ◽  
Author(s):  
Daniela Machado Lopes ◽  
Ana Rodríguez-Carmona ◽  
Teresa García Falcón ◽  
Andrés López Muñiz ◽  
Tamara Ferreiro Hermida ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Water Transport ◽  
Time Course ◽  
Free Water ◽  
Control Group ◽  
First Year ◽  
Study Group ◽  
Ultrafiltration Failure ◽  
Small Pore

BackgroundUltrafiltration failure (UFF) diagnosed at the initiation of peritoneal dialysis (PD) has been insufficiently characterized. In particular, few longitudinal studies have analyzed the time course of water transport in patients with this complication.ObjectiveTo investigate the time course of peritoneal water transport during the first year on PD in patients presenting UFF since the initiation of this therapy (study group).MethodProspective, observational, single-center design. We analyzed, at baseline and after 1 year of follow-up, peritoneal water transport in 19 patients incident on PD with UFF. We used incident patients without UFF as a control group. Water transport was characterized with the help of 3.86/4.25% dextrose-based peritoneal equilibration tests (PETs) with complete drainage at 60 minutes.ResultsThe study group revealed a disorder of water transport affecting both small-pore ultrafiltration (SPUF) ( p = 0.054 vs incident without UFF) and free water transport (FW T) ( p = 0.001). After 1 year of follow-up, FWT displayed a general increasing trend in the study group (mean variation 48.9 mL, 95% confidence interval [CI] 15.5, 82.2, p = 0.012), while the behavior of SPUF was less predictable (-4.8 mL, 95% CI -61.4, 71.1, p = 0.85). These changes were not observed in incident patients without UFF. Neither initial clinical characteristics, baseline PET-derived parameters, or suffering peritoneal infections during the first year predicted the time course of the capacity of UF in the study group. Recovery from incident UFF was apparently linked to improvement of SPUF.ConclusionsPatients with UFF at the start of PD suffer a disorder of peritoneal water transport affecting both FWT and SPUF. Free water transport increases systematically in these patients after 1 year of follow-up. The evolution of SPUF is less predictable, and improvement of this parameter marks reversibility of this complication.

scholarly journals The cellular contribution to effluent potassium and its relation to free water transport during peritoneal dialysis

2007 ◽  
Vol 22 (12) ◽  
pp. 3593-3600 ◽  
Author(s):  
A. M. Coester ◽  
D. G. Struijk ◽  
W. Smit ◽  
D. R. de Waart ◽  
R. T. Krediet
Keyword(s):  
Peritoneal Dialysis ◽  
Water Transport ◽  
Free Water

scholarly journals Peritoneal Water Transport Characteristics of Diabetic Patients Undergoing Peritoneal Dialysis: A Longitudinal Study

2017 ◽  
Vol 46 (1) ◽  
pp. 47-54 ◽  
Author(s):  
Ana Fernandes ◽  
Roi Ribera-Sanchez ◽  
Ana Rodríguez-Carmona ◽  
Antía López-Iglesias ◽  
Natacha Leite-Costa ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Water Transport ◽  
Free Water ◽  
Volume Overload ◽  
Diabetic Patients ◽  
Longitudinal Analyses ◽  
Cross Sectional ◽  
Sodium Removal ◽  
Essential Stability ◽  
Stability Of Water

Background: Volume overload is frequent in diabetics undergoing peritoneal dialysis (PD), and may play a significant role in the excess mortality observed in these patients. The characteristics of peritoneal water transport in this population have not been studied sufficiently. Method: Following a prospective, single-center design we made cross-sectional and longitudinal comparisons of peritoneal water transport in 2 relatively large samples of diabetic and nondiabetic PD patients. We used 3.86/4.25% glucose-based peritoneal equilibration tests (PET) with complete drainage at 60 min, for these purposes. Main Results: We scrutinized 59 diabetic and 120 nondiabetic PD patients. Both samples showed relatively similar characteristics, although diabetics were significantly more overhydrated than nondiabetics. The baseline PET disclosed lower ultrafiltration (mean 439 mL diabetics vs. 532 mL nondiabetics, p = 0.033) and sodium removal (41 vs. 53 mM, p = 0.014) rates in diabetics. One hundred and nine patients (36 diabetics) underwent a second PET after 12 months, and 45 (14 diabetics) underwent a third one after 24 months. Longitudinal analyses disclosed an essential stability of water transport in both groups, although nondiabetic patients showed a trend where an increase in free water transport (p = 0.033) was observed, which was not the case in diabetics. Conclusions: Diabetic patients undergoing PD present lower capacities of ultrafiltration and sodium removal than their nondiabetic counterparts. Longitudinal analyses disclose an essential stability of water transport capacities, both in diabetics and nondiabetics. The clinical significance of these differences deserves further analysis.

Free Water Transport and its Association with Cardiovascular Status in Children on Peritoneal Dialysis

2019 ◽  
Vol 39 (4) ◽  
pp. 323-329
Author(s):  
Lilian Bolte ◽  
Maria Jose Ibacache ◽  
Iris Delgado ◽  
Francisco Cano
Keyword(s):  
Peritoneal Dialysis ◽  
Left Ventricular Hypertrophy ◽  
Water Transport ◽  
Ventricular Hypertrophy ◽  
Roc Analysis ◽  
Characteristic Curve ◽  
Negative Relationship ◽  
Free Water ◽  
Inverse Correlation ◽  
Left Ventricular

BackgroundVolume overload is one of the most important factors associated with left ventricular hypertrophy (LVH) and cardiovascular disease in chronic peritoneal dialysis (PD) patients. MiniPET is a reliable tool to evaluate free water transport (FWT). In a clinical setting, the significance of FWT has not been evaluated in terms of outcome in children on PD. The objective was to define a FWT value of clinical significance in children on PD, fixing its relationship to left ventricular mass index (LVMI) as a well-known outcome parameter.MethodsMiniPET was performed with 3.86% glucose, 1-h long, to measure FWT in PD patients > 6 years old. An echocardiogram (ECG) was performed within 2 months of the MiniPET. Left ventricular hypertrophy was defined as LVMI ≥ 38.6 g/height2.7(95th percentile). Receiver operating characteristic curve (ROC) analysis was used to determine the cut-off value of FWT searching the highest sensitivity and specificity to differentiate patients with normal/abnormal LVMI. A p < 0.05 was considered significant.ResultsForty-six studies were performed on 32 patients, 16 males; mean age 11.59 ± 3.07 years. Mean normalized FWT (nFWT) was 144.4 ± 84.8 mL/m2, corresponding to 46.7% of total ultrafiltration. Mean LVMI was 42 ± 11.3 g/m2.7with a negative correlation to nFWT ( p < 0.01). Eighteen out of 32 patients had LVH. The ROC analysis (nFWT vs LVMI) showed an area under the curve of 0.71 (95% confidence interval [CI], 0.53 – 0.89; p = 0.04), allowing a cut-off nFWT value of 110 mL/m2to be defined, dividing the population into 2 groups of patients according to the LVMI cut-off value of 38,6 g/m2.7.ConclusionsThe nFWT showed an inverse correlation to LVMI. A nFWT value < 110 mL/m2was significantly associated with LVH. The negative relationship observed between nFWT and LVMI, and the cut-off level for nFWT according to the 95th percentile of LVMI, suggest that the regular evaluation of nFWT could become a useful tool in assessing the capacity of PD treatment to keep patients’ volume status under control, avoiding cardiovascular impairment.

Free Water Transport is Associated with Phosphorus Control in Patients at Initiation of Peritoneal Dialysis

2011 ◽  
Vol 31 (6) ◽  
pp. 685-687 ◽  
Author(s):  
Edyta Golembiewska ◽  
Joanna Kabat–Koperska ◽  
Krzysztof Safranow ◽  
Kazimierz Ciechanowski
Keyword(s):  
Peritoneal Dialysis ◽  
Water Transport ◽  
Free Water ◽  
Phosphorus Control

scholarly journals The contribution of free water transport and small pore transport to the total fluid removal in peritoneal dialysis

2005 ◽  
Vol 68 (4) ◽  
pp. 1849-1856 ◽  
Author(s):  
Alena Parikova ◽  
Watske Smit ◽  
Dirk G. Struijk ◽  
Machteld M. Zweers ◽  
Raymond T. Krediet
Keyword(s):  
Peritoneal Dialysis ◽  
Water Transport ◽  
Free Water ◽  
Fluid Removal ◽  
Small Pore ◽  
Total Fluid

scholarly journals High-dose steroid treatment increases free water transport in peritoneal dialysis patients

2011 ◽  
Vol 26 (12) ◽  
pp. 4142-4145 ◽  
Author(s):  
J. de Arteaga ◽  
F. Ledesma ◽  
G. Garay ◽  
C. Chiurchiu ◽  
J. d. l. Fuente ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Water Transport ◽  
Free Water ◽  
Steroid Treatment ◽  
High Dose ◽  
Dialysis Patients ◽  
High Dose Steroid

scholarly journals The Natural Time Course of Membrane Alterations during Peritoneal Dialysis is Partly Altered by Peritonitis

2016 ◽  
Vol 36 (4) ◽  
pp. 448-456 ◽  
Author(s):  
Sadie van Esch ◽  
Dirk G. Struijk ◽  
Raymond T. Krediet
Keyword(s):  
Peritoneal Dialysis ◽  
Time Course ◽  
Free Water ◽  
Natural Course ◽  
Ultrafiltration Rate ◽  
Pronounced Increase ◽  
Continuous Increase ◽  
Single Episode ◽  
Small Solute

Background The quality of the peritoneal membrane can deteriorate over time. Exposure to glucose-based dialysis solutions is the most likely culprit. Because peritonitis is a common complication of peritoneal dialysis (PD), distinguishing between the effect of glucose exposure and a possible additive effect of peritonitis is difficult. The aim of the present study was to compare the time-course of peritoneal transport characteristics in patients without a single episode of peritonitis—representing the natural course—and in patients who experienced 1 or more episodes of peritonitis during long-term follow-up. Methods This prospective, single-center cohort study enrolled incident adult PD patients who started PD during 1990–2010. A standard peritoneal permeability analysis was performed in the first year of PD treatment and was repeated every year. The results in patients without a single episode of peritonitis (“no-peritonitis group”) were compared with the results obtained in patients who experienced 1 or more peritonitis episodes (“peritonitis group”) during a follow-up of 4 years. Results The 124 patients analyzed included 54 in the no-peritonitis group and 70 in the peritonitis group. The time-course of small-solute transport was different in the groups, with the peritonitis group showing an earlier and more pronounced increase in the mass transfer area coefficient for creatinine ( p = 0.07) and in glucose absorption ( p = 0.048). In the no-peritonitis group, the net ultrafiltration rate (NUFR) and the transcapillary ultrafiltration rate (TCUFR) both showed a steep increase from the 1st to the 2nd year of PD that was absent in the peritonitis group. Both groups showed a decrease in the NUFR after year 3. A decrease in the TCUFR occurred only in the peritonitis group. That decrease was already present after the year 1 in patients with severe peritonitis. The time-course of free water transport showed a continuous increase in the patients without peritonitis, but a decrease in the patients who experienced peritonitis ( p < 0.01). No difference was observed in the time-course of the effective lymphatic absorption rate. The time-courses of immunoglobulin G and α2-macroglobulin clearances showed a decrease in both patient groups, with a concomitant increase of the restriction coefficient. Those changes were not evidently influenced by peritonitis. The two groups showed a similar decrease in the mesothelial cell mass marker cancer antigen 125 during follow-up. Conclusions On top of the natural course of peritoneal function, peritonitis episodes to some extent influence the time-course of small-solute and fluid transport—especially the transport of solute-free water. Those modifications increase the risk for overhydration.

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