Evaluation of Intraperitoneal Pressure and the Effect of Different Osmotic Agents on Intraperitoneal Pressure in Children

Abstract

Objectives To establish intraperitoneal pressure (IPP) in a relatively large pediatric study group and to study the effects of a 3.86% glucose solution and a 7.5% icodextrin solution on IPP during a 4-hour dwell. Design IPP was measured with the patient in a supine position. The intraperitoneal volume (IPV) was 1200 mL/m2 with a 1.36% glucose solution. The influence of dialysis solutions was obtained by performing two 4-hour peritoneal equilibration tests (PETs) with 3.86% glucose and 7.5% icodextrin as test solution, using an IPV of 1200 mL/m2 and dextran 70 as volume marker. IPP was measured at two consecutive time points ( t = 0 and t = 240 minutes). Transcapillary ultrafiltration, net ultrafiltration, and marker clearance were calculated. Patients IPP was established in 30 patients with median age of 4.5 years (range 1.0 – 14.9 years). Influence of dialysis solutions on IPP was studied in 9 children with median age of 4.2 years (range 1.7 – 10.9 years) and median treatment period of 12 months (range 5.6 – 122.3 months). Results Mean IPP was 12.0 ± 6.5 cm H2O. Significant relations were found between the change in IPP and transcapillary ultrafiltration and body surface area during the PET with 3.86% glucose. No relations were seen during the PET with icodextrin. Conclusions IPP was established in a large pediatric study group and was similar to previously published values of IPP in a small number of patients. Differences in fluid kinetics have different effects on the change in IPP during a 4-hour dwell period.

Intraperitoneal Pressure in Polycystic and Non-Polycystic Kidney Disease Patients, Treated by Peritoneal Dialysis

“…In this context, it is not surprising that in some studies, waist circumference significantly correlated with IPP [10]. This differs in paediatric population, where visceral fat is less relevant and BSA truly reflects the growth of the children, so that for a given IPV, small children with small BSA develop more IPP than those with higher BSA [19].…”

An App Predicting Peritoneal Dialysis Appropriate Dwell Volume for Patients in Daily Quality-of-Care Practice

“…Theoretically, increasing DV recruits more peritoneal membrane surface area for better uremic toxin clearance and larger UF volume. Many studies have revealed a negative linear correlation between mean IPP and UF volume [7,9]. Other studies addressed that patients are well tolerated by adult and pediatric PD patients with subjective discomfort judgment when the IPP levels are maintained at less than 18 cm H 2 O and reaching optimal UF volumes [7,10].…”

“…Many studies have revealed a negative linear correlation between mean IPP and UF volume [7,9]. Other studies addressed that patients are well tolerated by adult and pediatric PD patients with subjective discomfort judgment when the IPP levels are maintained at less than 18 cm H 2 O and reaching optimal UF volumes [7,10]. Applying IPP measurement as part of adjusting DV can thus be decided along with the subjective tolerance levels of adult patients and the objective observation by a physician in clinical settings.…”

Adaptuota Automatinė Peritoninė Dializė: Užpylimo Tūrio Ir Ekspozicijos Laiko Varijavimo Svarba

“…PD efficiency varies with prescribed fill volume but it is well known that optimal fill volume is a patient's individual parameter [12,13] which should be adapted to the patient's body surface area [1,6]. If the dialysis target is to remove more uremic toxins we should use larger intraperitoneal volumes (IPV) because they increase the peritoneal surface area available for the exchange and enable to achieve greater solutes clearance [7,12,14,15].…”