Slingeneyer A, Sablo J, Laroche B, Mion C
APEX Time (Accelerated Peritoneal Examination) is a more
sensible tool than simplified PET for follow-up of long term
peritoneal alterations
XVIth Annual CAPD Conference
Perit Dial Int Suppl 2
(Feb) 16:S12 1996
The authors compare the evolution of APEX time and
PET in CAPD patients over a four year period. APEX-time is the time at
which urea and glucose equilibration curves cross each other during an
equilibration test. One hundred thirty-three concomitant APEX times
and PETs were assessed in 103 patients. Seventy-one tests were performed
during the 1st month, 31 in year 1, 17 during years 2 and 3, and
14 after year 3.
A significant increase in APEX time was detected over time, from 59 to 87
minutes.
D/P creatinine and UF did not change, whereas D/P urea decreased slightly but
significantly.
When 1st and last results were compared by paired test in the 14 patients
followed more than
36 months, a significant lengthening of the APEX time was also
demonstrated.
The authors conclude that APEX time is more sensitive than
D/P and PET to detect slight changes in membrane function over time, and that
such changes might be related to structural alteration that would not be
otherwise detected.
Comment: The APEX time was designed several years ago by
our group and is widely used in France.
Using this test, the authors did appear to demonstrate a decrease in
peritoneal
permeabilty over a 3 year plus period, a finding which was not apparent on
conventional PET. However the APEX time remained in the normal
range. The results are valuable in the information they give on the
group of patients studied as a whole, but such small variations are not
of clinical importance to the individual patient. (Christian Verger,
M.D., Pointoise,
France)
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XVIth Annual CAPD Conference
Basic peritoneal dialysis :
PET testing