CHANGES IN THE PERITONEAL EQUILIBRATION TEST IN SELECTED CHRONIC PERITONEAL-DIALYSIS PATIENTS

Fifty-five patients on chronic peritoneal dialysis with two or more pe ritoneal equilibration tests (PET) performed between 1983 and 1992 wit h a mean interval of 21.9 +/- 22.7 months were studied retrospectively . Repeated PET were performed when transport changes were suspected ra ther than routinely. According to the initial PET, there were 16 high (HI), 17 high-average (HA), 15 low-average (LA), and 7 low (LO) transp orters. There was a significant decrease in the mean creatinine dialys ate to plasma ratio (D/ P creatinine) in the HI transporters and an in crease in the LA and LO transporters. The mean dialysate to instilled glucose ratio (D/Do) significantly increased in the HI transporters. T he change in both the D/P creatinine and the D/Do of an individual str ongly and inversely correlated to their respective initial values. The change in D/P creatinine and D/Do were significantly and inversely co rrelated to each other, indicating an actual transport change. No corr elation was found between the change in transport with peritonitis epi sodes or frequencies. The centrifugal change of transport toward avera ge described here may explain why low clearances or low ultrafiltratio n rates due to rapid transport are infrequent causes of peritoneal dia lysis technique failure, and why patients who have been dialyzed for a long period are usually HA transporters.