Physiological properties of the peritoneum in an adult peritoneal dialysis population over a three-year period

Abstract

◆ Objectives: To describe the physiological properties of the peritoneal membrane in adult patients treated with peritoneal dialysis (PD) and to analyze the effects of patient characteristics and time. ◆ Design: Observational study. ◆ Setting. Departmentof Nephrology at the Sahlgrenska University Hospital. ◆ Method. Peritoneal function was analyzed by the Personal Dialysis Capacity (PDC) test, based on the three-pore theory of capillary transport. The functional PDC variables are absorption, large-pore flow, and the area parameter (A0/Δx), which determines the diffusion of small solutes. The ultrafiltration (UF) coefficient is determined mainly by A0/Δx. ◆ Patients: All patients (n = 280) who had at least one PDC test done between September 1990 and August 1999. ◆ Results: In 249 patients examined soon after start of PD, area was 19000 (SD 7100) cm2/cm/1.73 m2, large-pore flow 0.112 (SD 0.052) mL/ min/1.73 m2, and the UF coefficient 0.071 (SD 0.032) mL/minute/mmHg/ 1.73 m2. Absorption was 1.54 (SD +2.64, -0.97) mL/min/1.73 m2. Large-pore flow was greater in patients with severe comorbidity than in patients with fewer comorbid conditions. Elderly patients had a lower UF coefficient than did younger patients (p < 0.05). Repeated PDC tests were performed in 208 patients during a mean observation time of 18.4 months. There was a slight increase in the slope of the area-versus-time curve of 54 cm2/cm/1.73 m2 per month (approximately 10% after 3 years, p < 0.01); all other parameters remained constant. ◆ Conclusion: Patient characteristics have an impact on peritoneal performance already at the start of dialysis. Peritoneal function can remain essentially stable during medium long-term PD. Copyright © 2006 International Society for Peritoneal Dialysis.