Longitudinal evaluation of transport kinetics in children receiving peritoneal dialysis

Functional stability of the peritoneal membrane is necessary for maintenanc e of peritoneal dialysis (PD) as a therapeutic option. Few studies have inv estigated this issue in children. We evaluated the peritoneal membrane solu te transport capacity longitudinally in 26 children (mean age 11.0+/-5.5 ye ars) receiving longterm PD, Each patient underwent a standardized peritonea l equilibration test on two occasions (mean interval between studies 19.8+/ -5.9 months) to determine solute dialysate to plasma (D/P) ratios, dialysat e glucose to initial dialysate glucose (D/D-0) ratios, and mass transfer ar ea coefficients (MTAC). The correlation of transport capacity with peritoni tis history was also assessed. No significant change in MTAC, D/P, or D/D-0 values were found when comparing original and follow-up data of the group overall. However, transport of creatinine and glucose was significantly (P< 0.05) greater in the peritonitis group compared with the group without peri tonitis, and differences in the change over time between the peritonitis gr oups was significant for MTAC creatinine (P=0.035) and D/D-0 glucose (P=0.0 20). In summary, this experience demonstrates functional stability of the p eritoneal membrane in pediatric patients receiving PD. However, follow-up a ssessments of peritoneal solute kinetics may be necessary in patients with a history of peritonitis in order to permit early identification of those w ho may be at risk for ultrafiltration failure and sclerosing peritonitis.