Ultrafiltration in Patients on Automated Peritoneal Dialysis with Homechoice Claria connected to Sharesource: A Pilot Study

Abstract

Introduction: Fluid overload is an unavoidable problem in patients on peritoneal dialysis (PD) and is associated with poor outcomes. The aim of our study was to estimate ultrafiltration (UF) under different dextrose concentrations and clarify possible predictors of UF.Materials and methods: Seventy patients, with 1848 daily treatment records and 8266 single dwells on automated PD through Homechoice Claria with Sharesource were followed in October 2020 and categorized into 2 groups according to the dextrose concentration (group D1.5% and D2.5%). Baseline characteristics, peritoneal membrane characteristics, and daily PD treatment records from Sharesource were obtained. We compared UF under the different conditions.Results: Multivariate linear regression revealed that the mean fill volume (FV) per cycle (p=0.006) and dextrose concentration (p=0.000) were independent predictors of UF. The mean night UF per cycle, the mean night UF corrected by FV per cycle, and the mean night UF corrected by FV and dwelling time (DT) per cycle were 95.8 ml, 5.5%, and 5.0 ‱/minutes in group D1.5% and 220.3 ml, 12.0%, and 11.6 ‱/minutes in group D2.5%, respectively. After an approximately 120-minute DT, there was a trend toward higher UF in the low peritoneal permeability group and lower UF in the high peritoneal permeability group.Conclusion: This retrospective study presents precise UF measurements with two solutions at different dextrose concentrations and four peritoneal transport levels. UF is positively correlated with DT and FV of the dialysate within a reasonable range. High peritoneal permeability is associated with decreased UF, and low peritoneal permeability requires a longer DT to reach the maximal UF.