Piraino B, Bernardini J
Dialysate/plasma urea and creatinine in 24 hour clearance
studies in CAPD, CCPD, and NPD
17th Annual CAPD Conference
Perit Dial Int Suppl 1
(Feb) 17:S9 1997
It is generally assumed in CAPD that urea equilibration is in excess
of 90% and sometimes as high as 100%. The investigators measure
equilibration ratios for urea and creatinine in 452 clearance studies
[359 on CAPD, 72 on CCPD, 21 on NPD]. Mean equilibration ratios for
urea are 0.88 on CAPD, 0.73 on CCPD and 0.64 on NPD. For creatinine
the numbers are 0.70, 0.54 and 0.44, respectively. The range for urea
on CAPD is from 0.5 to 1.2. The authors conclude that, on average,
urea equilibration on CAPD is not as high as people have suspected;
they suggest that this may relate to at least some of the exchanges in
many patients being less than 4 hours. They conclude that full
equilibration for urea should not be assumed on CAPD.
It has been reported before that urea equilibration ratios in CAPD
differ in some populations from as low as 0.85 to as high as 0.95.
This likely reflects differences in dwell duration in some patients,
as the authors suggest. It also may be affected by excessive flushing
in `flush-before-fill' giving sets. Other patients are, of course,
genuinely low transporters and so, even when they comply with their
prescription, still do not achieve full equilibration. This study
again emphasizes the importance of measuring rather than predicting
clearances in PD patients. (Peter G. Blake, M.D., Victoria
Hospital, London, Ontario)
To go back use the BACK button on your browser.
Otherwise click on the desired link to this article below:
17th Annual CAPD Conference
Basic peritoneal dialysis :
Chronic PD regimens, adequacy, modeling