Fishbach M, Terzic J, Dangelser Cl, Schneider Ph, Roger ML,
Geisert J
Effect of posture on intraperitoneal pressure (Pip) and
peritoneal permeability in children
17th Annual CAPD Conference
Perit Dial Int Suppl 1
(Feb) 17:S84 1997
Children with ESRD are often placed on overnight CCPD to allow more
daytime freedom. This report suggests further benefits. The effect on
posture on intraperitoneal pressure and the short PET test was studied
in three children using a constant dialysate exchange volume. A 90
minute PET test was performed in the supine and upright posture. The
dialysis to plasma ratio demonstrated an improved urea desaturation rate
in the supine position (approximately 0.63 supine vs. 0.54 upright) as
well as more rapid glucose absorption (glucose dialysate desaturation
rate per hour about 0.43 supine vs. 0.52 upright). A large drop in Pip
was observed between the upright and supine postures (17.4 and 11.6 cm
H20 respectively) but only a minimal drop in UF rate was noted. This
may have been due to the slower glucose transfer observed in the upright
posture.
Comment: It would appear from this study that not only lifestyle is
improved with overnight PD. The supine posture is more comfortable
(lower Pip) and may offer better solute clearance. A larger scale long
term trial is warranted before definitive conclusions can be
established.
(Sri Narsipur, MD, SUNY-HSC at Syracuse, NY)
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17th Annual CAPD Conference
Basic peritoneal dialysis :
Physiology
CRF by problem area :
CRF in infants and children