2018
DOI: 10.3747/pdi.2017.00219
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A Large Intraperitoneal Residual Volume Hampers Adequate Volumetric Assessment of Osmotic Conductance to Glucose

Abstract: A large RV leads to significant overestimation of OCG using the double mini-PET, potentially reducing the ability of OCG to identify patients with progressive fibrosis in the peritoneal interstitium. On the other hand, sieving of the dialysate sodium, a biochemical surrogate for OCG, is independent of the RV and may therefore be more reliable. A call for caution is warranted in patients with a large RV to avoid misinterpretation of OCG values derived from the double mini-PET.

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Cited by 14 publications
(9 citation statements)
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References 21 publications
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“…Here we developed an easy, robust, and accurate method to determine OCG on the basis of a single 60minute 4.25% glucose dwell. In line with recent results, 7 our data confirm that the dm-PET provides a strikingly poor estimate of OCG for individual patients. Our data show that including the variation of RVs between dwells in the dm-PET methodology dramatically improved the correlation with osmotic water transport.…”
Section: Discussionsupporting
confidence: 88%
See 2 more Smart Citations
“…Here we developed an easy, robust, and accurate method to determine OCG on the basis of a single 60minute 4.25% glucose dwell. In line with recent results, 7 our data confirm that the dm-PET provides a strikingly poor estimate of OCG for individual patients. Our data show that including the variation of RVs between dwells in the dm-PET methodology dramatically improved the correlation with osmotic water transport.…”
Section: Discussionsupporting
confidence: 88%
“…5 However, the dm-PET is usually performed without consideration of RVs and actual dialysate glucose concentrations, which means that large errors could arise in the estimation of UF (and OCG). 6,7 Interestingly, the estimation of OCG has also been performed on the basis of a single dwell as nicely reported by Parikova et al 8 In the present study, we developed a simplified method to determine OCG based on a single 1-hour 4.25% dwell with RV determination pre-and postexchange and validated the novel method in a discovery cohort and in an independent validation cohort. To facilitate clinical use of the single-dwell methodology, we developed a mobile app.…”
supporting
confidence: 69%
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“…Because the sodium dip reflects the proportion of fluid travelling across the membrane without solute (in this case sodium), it is also referred to as 'free water transport'. The sodium dip, as defined later in more detail, (section underpinning guideline 4a) is a reliable surrogate for OCG, 72 and it is of note that reduced dip was identified as the only independent predictor of the risk of developing UF failure during the course of PD in an Italian cohort. 73 The reason for such inter-individual variability in OCG already at the start of PD remains unknown but may potentially be explained by genetic polymorphisms, as observed for PSTR.…”
Section: Classification Of Causes Of Membrane Dysfunction Based On Cumentioning
confidence: 99%
“…Lastly, we conclude that the reasons for the discrepancy between the lower small solute clearances simulated herein and those measured in previous experimental studies remain obscure. Surely, in many patients, the residual volume may significantly contribute to the net IPV and, if not taken into account, a large residual volume may make impossible any modeling approach based on a small or constant IPV (25). Thus, further experimental research, taking the IPV into account, is clearly needed to cast light on this issue.…”
Section: Discussionmentioning
confidence: 99%