Dialysis adequacy and transport test for characterization of peritoneal transport type in Chinese peritoneal dialysis patients receiving three daily exchanges

Abstract

Dialysis adequacy and transport test (DATT) is an accurate method to classify peritoneal transport type for continuous ambulatory peritoneal dialysis (CAPD) patients with a regimen of four exchanges of 2 L/d. We examined the accuracy of DATT for the characterization of peritoneal transport type in patients with a regimen of three exchanges of 2 L/d, which is the standard CAPD regimen in Hong Kong Chinese. We studied 189 adult Chinese CAPD patients with a prescription of three exchanges of 2 L/d. Patients who had a peritonitis episode within the previous 30 days were excluded. Standard peritoneal equilibration test (PET) and DATT were performed on consecutive days. Correlation coefficients between dialysate-to-plasma ratios of creatinine (D/P) obtained for the PET and the DATT was 0.698 (P < 0.001). Peritoneal transport type was classified according to the reported D/P creatinine reference values obtained from the PET at 4 hours. When the result was compared with the transport type classified by the DATT result using the linear regression formula derived, the Cohen kappa was 0.433 (95% confidence interval, 0.329 to 0.537), which could be regarded as a moderate level of agreement. For classification of the low transporters, the specificity of DATT was 90.1%, and sensitivity was 72.3%. For classification of the high transporters, the specificity of DATT was 96.6%, and sensitivity was 57.1%. DATT and PET had a reasonable agreement in the classification of peritoneal transport type for Chinese CAPD patients receiving a daily schedule of three exchanges of 2 L/d. Although DATT may be less accurate for CAPD patients with three daily exchanges, it remains a specific method to identify low and high transporters.