Standardized peritoneal equilibration test in Japanese children and the influence of long-term peritoneal dialysis

Abstract

Objective: To establish a standardized method and standard values of peritoneal equilibration test (PET) in children and to elucidate the factors influencing peritoneal permeability, we standardized the method of PET in the leading hospitals of the Japanese Study Group of Pediatric Peritoneal Dialysis.

Methods: Using 2.5% glucose dialysate and an infusion volume of 1,100 mL/m(2) body surface area (BSA), we performed 202 standardized PETs. The patients within 1 month of a peritonitis episode were excluded.

Results: The-1 standard deviation (SD), mean, and +1 SD values of end dialysate-to-initial dialysate ratio of (D/D(0)) glucose were 0.31, 0.41, and 0.51 respectively. The dialysate-to-plasma ratios (D/P) of creatinine were 0.52, 0.65, and 0.78. These values were similar to those of Twardowski's adult PET, although previous reports about standardized pediatric PET described more permeable values. Because the duration of PD was longer in the study patients, peritoneal permeability was increased significantly in patients with and without experience of peritonitis alike. The slope indices of the regression equations between the duration of PD and peritoneal permeability in the two groups were same.

Conclusions: Standardized PET in Japanese children with 2.5% glucose dialysate and an infusion volume of 1,100 mL/m(2) BSA produces standard values similar to those of Twardowski's adult PET. This standardized method of PET is suitable for pediatric PD patients, and peritoneal permeability in children is not higher than that in adults. In addition, the study data show that long-term peritoneal dialysis worsens peritoneal function more than experience of peritonitis does.