CHANGES IN PERITONEAL TRANSPORT DURING THE FIRST MONTH OF PERITONEAL-DIALYSIS

Objective: To determine if peritoneal transport characteristics change during the initial month of peritoneal dialysis. Design: Retrospectiv e review of peritoneal equilibration test (PET) results in patients wh o received their first PET during the first two weeks of peritoneal di alysis (early PET group) versus patients who received their first PET between four and 28 weeks after the initiation of dialysis (late PET g roup), The initial PET values were compared to subsequent PET results obtained approximately seven months after the initial PET. Setting: Pe ritoneal dialysis unit of a tertiary medical center. Outcome Measures: PET results and calculated mass transfer area coefficient (MTAC) valu es. Patients: Thirty-four peritoneal dialysis patients in the early PE T group and 17 peritoneal dialysis patients in the late PET group. Res ults: In the early PET group, there was a statistically significant in crease from the initial to follow-up values for both dialysate-to-plas ma (DIP) creatinine and MTAC creatinine (p < 0.01) as well as a signif icant decrease for four-hour dialysate to initial dialysate ratios (D/ D-degrees) glucose (p = 0.08) and MTAC glucose (p < 0.05), In the late PET group, there was no significant change in any of these parameters with time. However, in the late PET group, there was a significant de crease in D/P urea values with time (p < 0.01), but not with MTAC urea . In addition, there were no differences over time in either group for serum albumin or hematocrit values. Conclusion: During the first two weeks of peritoneal dialysis, there tends to be a change in peritoneal transport characteristics in some patients. PET data obtained during this time period should be interpreted as preliminary.