DETERMINATION OF PERITONEAL TRANSPORT CHARACTERISTICS WITH 24-HOUR DIALYSATE COLLECTIONS - DIALYSIS ADEQUACY AND TRANSPORT TEST

Although the 24-hour collection of dialysate provides a very accurate measure of the adequacy of dialysis, it is not known if it can also de termine peritoneal membrane transport characteristics. In this prospec tive study, 101 24-hour dialysate collections were immediately followe d by a standard peritoneal equilibration test (PET). Four- and 24-h di alysate-to-plasma (D/P) ratios were determined for creatinine and urea . The correlation coefficients between these two tests were 0.86 for t he adjusted D/P creatinine and 0.71 for the D/P urea, whereas the stan dard errors of estimate were 0.054 and 0.060, respectively. Patients w ere classified into one of four transport groups on the basis of the m ean and standard deviation of the adjusted D/P creatinine values, and these values were similar to those generated from the PET data. Rates of ultrafiltration were also defined for patients undergoing 2.0 and 2 .5-L dwells. A survey of a subset of these patients demonstrated that the 24-h collection was preferred to the PET for determining transport characteristics. Therefore, the 24-h dialysate collection can be used to monitor both peritoneal membrane transport characteristics and ade quacy. This technique, which has been named the ''dialysis adequacy an d transport test,'' has the potential for significant cost savings whe n it is used for the routine follow-up of both peritoneal transport an d adequacy of dialysis.