Survival of Peritoneal Membrane Function on Biocompatible Dialysis Solutions in a Peritoneal Dialysis Cohort Assessed by a Novel Test

Olga Balafa; Anila Duni; Paraskevi Tseke; Karolos Rapsomanikis; Paraskevi Pavlakou; Margarita Ikonomou; Vasileios Tatsis; Evangelia Dounousi

doi:10.3390/jcm10163650

Survival of Peritoneal Membrane Function on Biocompatible Dialysis Solutions in a Peritoneal Dialysis Cohort Assessed by a Novel Test

J Clin Med. 2021 Aug 18;10(16):3650. doi: 10.3390/jcm10163650.

Authors

Olga Balafa¹, Anila Duni¹, Paraskevi Tseke², Karolos Rapsomanikis¹, Paraskevi Pavlakou¹, Margarita Ikonomou¹, Vasileios Tatsis³, Evangelia Dounousi¹

Affiliations

¹ Department of Nephrology, University Hospital of Ioannina, 45500 Ioannina, Greece.
² Department of Nephrology, General Hospital Alexandra, 11528 Athens, Greece.
³ Department of Surgery, University Hospital of Ioannina, 45500 Ioannina, Greece.

Abstract

Background: Longitudinal surveillance of peritoneal membrane function is crucial in defining patients with a risk of ultrafiltration failure. Long PD is associated with increased low molecular weight solute transport and decreased ultrafiltration and free water transport. Classic PET test only provides information about low molecular solute transport, and the vast majority of longitudinal studies are based on this test and include patients using conventional dialysates. Our aim was to prospectively analyze longitudinal data on peritoneal function in patients on biocompatible solutions using a novel test.

Methods: Membrane function data were collected based on uni-PET (a combination of modified and mini PET). A total of 85 patients (age 61.1 ± 15.1 years) with at least one test/year were included.

Results: The median follow up was 36 months (21.3, 67.2). A total of 219 PETs were performed. One-way repeated measures ANOVA showed that there were no statistically significant differences over time in ultrafiltration, free water transport, ultrafiltration through small pores, sodium removal, D/D0 and D/PCre in repeated PET-tests. Twenty-three tests revealed ultrafiltration failure in 16 (18.8%) patients. Those patients were longer on PD, had higher D/P creatinine ratios, lower ultrafiltration at one hour with lower free water transport and higher urine volume at baseline. Multivariate analysis revealed that the variation of ultrafiltration over repeated PET-tests independently correlated only with D/Pcreatinine, free water transport and ultrafiltration through small pores.

Conclusions: Uni-PET is a combination of two tests that provides more information on the function of the membrane compared with PET. Our study on a PD cohort using only biocompatible solutions revealed that function membrane parameters remained stable over a long time. Ultrafiltration failure was correlated with increased D/P creatinine and decreased free water transport and ultrafiltration through small pores.

Keywords: biocompatible; dialysis; longitudinal; technical survival.