The effect of dialysate dwell on gastric emptying time in patients on continuous ambulatory peritoneal dialysis

Methods and Patients: We evaluated gastric emptying time (GET) with a techn etium (Tc) 99(m)-sulfur colloid gastric emptying scan in 11 patients on con tinuous ambulatory peritoneal dialysis (CAPD) (6 males, 5 females) and in 1 4 controls. We investigated the effect of dialysate dwell on GET by studyin g the subjects twice: once without dialysate in the abdomen (drained) and o nce with 2 L of dialysate in the abdomen (full). We also investigated the r elationship between body surface area (BSA) and delayed gastric emptying. Results: (1) The mean gastric emptying rate in 120 minutes in patients on C APD when drained (67.8% +/- 13.4%) was not different from that in controls (65.4% +/- 8.6%). (2) The mean gastric emptying rate in 120 minutes in pati ents on CAPD when full was significantly slower than that when drained (55. 6% +/- 14.6% versus 67.8% +/- 13.4%, p < 0.05). In four of the 11 patients (36.4%), gastric emptying was extremely delayed from normal to abnormal ran ge when full. (3) The BSA of patients who had extremely delayed GET from no rmal to abnormal range was smaller than that of patients who had minimal de layed or unchanged GET when full (1.5 +/- 0.11 m(2) versus 1.74 +/- 0.22 m( 2)). Conclusion:This study showed that patients on CAPD had normal gastric empty ing when drained, and that gastric emptying was delayed by dialysate dwell, especially in patients who has less than 1.5 m2 of body surface area. Ther efore, we suggest that, based on adequacy, intermittent nocturnal peritonea l dialysis or a small volume of dialysate be considered for patients with s mall body surface area.