Peritoneal Kinetics in Children Undergoing Continuous Ambulatory/Cycling Peritoneal Dialysis

Lilien, Tassilo von; Salusky, Isidro B.; Little, Roderick J. A.; Alliapolous, John C.; Leichter, Heinz E.; Hall, Theodore R.; Fine, Richard Ν.

doi:10.1016/s0272-6386(87)80189-0

Cited by 13 publications

(7 citation statements)

References 27 publications

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“…Whilst there is general acceptance within the CAPD literature that peritonitis is harmful to the peritoneum, and a major cause of ultrafiltration failure, the actual data and documentation in support of this phenomenon is poor and controversial. Several studies have been unable to establish a link between peritonitis and changes in peritoneal function [22][23][24][25], and those which have [5,6,26,27], with the exception of that by Selgas et al [7], have either been in small selected groups of patients, or have inferred the changes in peritoneal kinetics from the requirements of hypertonic solutions or clinical outcome, rather than performing actual measurements. There are several potential reasons as to why this lack of clarity persists in the literature, which we have attempted to rectify in this study.…”

Section: Discussionmentioning

confidence: 99%

“…As with the published data on peritonitis and the peritoneum, longitudinal studies of peritoneal function are conflicting in their messages. Some studies with longitudinal data on small numbers of selected patients (less than 20) have failed to find significant changes with 4-5 years of treatment [24,25], whilst others have found a positive correlation between solute transfer 505 and time on treatment [23], or that patients on dialysis for several years tend to be 'high average' transporters [22]. Several studies have identified time spent on CAPD as a risk factor for developing clinical ultrafiltration failure [4][5][6].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Longitudinal changes in peritoneal kinetics: the effects of peritoneal dialysis and peritonitis

Davies

Bryan

Phillips

et al. 1996

Nephrology Dialysis Transplantation

205

142

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Longitudinal changes in peritoneal kinetics: the effects of peritoneal dialysis and peritonitis

Davies

Bryan

Phillips

et al. 1996

Nephrology Dialysis Transplantation

205

142

View full text Add to dashboard Cite

show abstract

“…Our patients, however, were matched for time on PD and analyzed as matched pairs, thereby reducing the difference in chronic changes in the peritoneal membrane between the two groups. Also, previous authors have shown no difference in small solute transport creatinine clearance or TCUF in children on chronic PD up to 33 – 55 months (23-25). As the longest time on PD was 52 months, it is unlikely that any long-term effects on the peritoneal membrane had yet taken place.…”

Section: Discussionmentioning

confidence: 81%

No Significant Differences in Peritoneal Fluid Handling in Children Using pH-Neutral or Acidic Solutions

Nourse

Kar²,

Willems³

et al. 2006

Perit Dial Int

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Objectives Differences in peritoneal fluid handling in the acute setting can be expected if children are converted to pH-neutral dialysis solutions because conventional acidic solutions exert toxic effects on peritoneal mesothelial cells and microcirculation. Peritoneal fluid kinetics was therefore investigated with both types of solutions in a group of children. Design Peritoneal equilibration tests (PETs) were performed in 12 patients [mean age 70 months, mean time on peritoneal dialysis (PD) 18 months] using a pH-neutral PD fluid (Physioneal 3.86%; Baxter Ltd, Castlebar, Ireland) and dextran 70 as a volume marker. The results of these PETs were compared to those of a historic group of 12 children (mean age 75 months, mean time on PD 17 months). Setting Pediatric dialysis unit in a tertiary institute. Patients Stable pediatric PD patients. Main Outcome Measures Transcapillary ultrafiltration (TCUF) and marker clearance, dialysate-to-plasma (D/P) ratios for urea and creatinine, and Dt/D0 ratio for glucose. Results TCUF and lymphatic absorption were not different between the two groups. There was also no significant difference in small solute clearance measured by D/P ratio for urea and creatinine and Dt/D0 ratio for glucose. Conclusion Peritoneal fluid kinetics is not significantly altered if pH-neutral dialysis solutions are applied compared to acidic solutions. An altered TCUF, as is hypothetically possible using an acidic solution, was not established.

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“…Data on follow-up of peritoneal fluid kinetics in childhood PD are not available. Warady et al (19) studied peritoneal transport of creatinine, urea, and glucose, using an IP volume of 1100 mL/m 2 (20). We therefore studied hydrostatic IP pressure during our follow-up PETs in some patients.…”

Section: Discussionmentioning

confidence: 99%

“…the technique has been improved and even younger patients can be treated, the preservation of the function of the peritoneal membrane in infants and children becomes more important. Studies on peritoneal clearances show no changes in creatinine clearance for up to 55 months of treatment (2), nor any changes in glucose transport across the peritoneum in children receiving dialysis for up to 28 months (3). No information is currently available about the followup of transcapillary ultrafiltration (TCUF) and marker clearance (MC) in children during long-term PD.…”

mentioning

confidence: 99%

Follow-Up Study of Peritoneal Fluid Kinetics in Infants and Children on Peritoneal Dialysis

Boer

Schaijk²,

Willems³

et al. 1999

Perit Dial Int

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Objectives To study longitudinal changes in trans-capillary ultrafiltration (TCUF) and marker clearance (MC), as a reflection of lymphatic absorption, in children on peritoneal dialysis (PD). To present data on fluid kinetics in infants younger than 2.5 years, using an intraperitoneal volume of 1200 mL/m2 body surface area (BSA). Design The study involved a 4-hour dwell of 1200 mL/m2 BSA of dialysis fluid containing 3.86% glucose with Dextran 70 as volume marker. Cumulative TCUF and cumulative MC were measured. Setting A tertiary-care university hospital. Patients A follow-up period of 33 months of serial (1 – 4) peritoneal equilibration tests (PETs) was studied in 20 children with a median age of 6.4 years (range 2.1 – 15.4 years). Fluid kinetics in 5 additional infants with a median age of 1.4 years (range 0.5 – 2.5 years) was measured. Results Cumulative TCUF was 1041 mL/1.73 m2 at 1 – 3 months after start of PD, 1026 mL/1.73 m2 at 7 – 9 months, 1021 mL/1.73 m2 at 11 – 13 months, and 756 mL/ 1.73 m2 at 26 – 33 months (NS). Cumulative MC was 235 mL/1.73 m2 at 1 – 3 months after start of PD, 311 mL/ 1.73 m2 at 7 – 9 months, 395 mL/1.73 m2 at 11 – 13 months, and 509 mL/1.73 m2 at 26 – 33 months (NS). In infants, cumulative TCUF was 755 ± 237 mL/1.73 m2; cumulative MC was 400 ± 214 mL/1.73 m2. Conclusions Transcapillary ultrafiltration and marker clearance do not change in children > 2.5 years during the period studied. Fluid kinetics does not differ between infants < 2.5 years and older children when intraperitoneal volumes of 1200 mL/m2 BSA are used.

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Peritoneal Kinetics in Children Undergoing Continuous Ambulatory/Cycling Peritoneal Dialysis

Cited by 13 publications

References 27 publications

Longitudinal changes in peritoneal kinetics: the effects of peritoneal dialysis and peritonitis

Longitudinal changes in peritoneal kinetics: the effects of peritoneal dialysis and peritonitis

No Significant Differences in Peritoneal Fluid Handling in Children Using pH-Neutral or Acidic Solutions

Follow-Up Study of Peritoneal Fluid Kinetics in Infants and Children on Peritoneal Dialysis

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