Background: The standard Peritoneal Equilibration Test (PET) utilises in peritoneal dialysis (PD) a 2.27% glucose dialysis solution. A more hypertonic solution (3.86%) has recently been recommended with a view to obtaining further information on ultrafiltration (UF).
Aim: To compare results, in term of peritoneal solute transport (4h-dialysate-to-plasma ratio [4h-D/P] for urea and creatinine), obtained with 2.27% and 3.86% PET.
Design: 23 patients on PD were randomised to form two groups, A and B. In the former a 2.27% dextrose 2-L exchange was followed, on the same day, by 3.86% dextrose 2-L exchange, both with a 4-hour dwell; in the latter, the same treatment was provided in reverse order. The 4h-D/P for urea, creatinine, phosphorus, uric acid, potassium and sodium at time 0, 60, 120 and 240 minutes and net UF were calculated for each PET and compared.
Results: No significant statistical differences were found between 2.27% and 3.86% PET for the usual peritoneal transport indexes, the results being almost identical.
The 4h-D/P were
0.67 ± 0.09 vs 0.66 ± 0.10 for creatinine (p= NS),
0.91 ± 0.04 vs 0.90 ± 0.04 for urea (p= NS) and
0.57 ± 0.17 vs 0.56 ± 0.17 for uric acid (p= NS).
The D/P for sodium resulted lower at all times in the 3.86% test:
D/P60= 0.92 ± 0.05 vs 0.88 ± 0.03,
D/P120= 0.91 ± 0.02 vs 0.87 ± 0.03,
D/P240= 0.92 ± 0.02 vs 0.88 ± 0.04 (p< 0.0001).
Net UF resulted 478 ± 175 vs 936 ± 233 mL (p< 0.0001).
Conclusion: Our study suggests that a 3.86% PD solution could be used in the PET to assess peritoneal solute transport and UF, obtaining almost exactly the same results as with the usual 2.27% solution.
