Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Sep;39(9):2753-2758.
doi: 10.1007/s00467-024-06383-9. Epub 2024 May 2.

Sodium removal per ultrafiltration volume in automated peritoneal dialysis in pediatric patients

Takashi Tokunaga  1   2 , Riku Hamada  3   4 , Tomohiro Inoguchi  1   5 , Chikako Terano  1   6 , Naoaki Mikami  1 , Ryoko Harada  1 , Yuko Hamasaki  1   7 , Kenji Ishikura  1   8 , Hiroshi Hataya  1   5   9 , Masataka Honda  1   10
Affiliations

Sodium removal per ultrafiltration volume in automated peritoneal dialysis in pediatric patients

Takashi Tokunaga et al. Pediatr Nephrol. 2024 Sep.

Abstract

Background: The standard rate of sodium removal in adult anuric patients on continuous ambulatory peritoneal dialysis (CAPD) is 7.5 g/L of ultrafiltration volume (UFV). Although automated PD (APD) is widely used in pediatric patients, no attempt has yet been made to estimate sodium removal in APD.

Methods: The present, retrospective cohort study included pediatric patients with APD who were managed at Tokyo Metropolitan Children's Medical Center between July 2010 and November 2017. The patients underwent a peritoneal equilibrium test (PET) at our hospital. Sodium removal per UFV was calculated by peritoneal function and dwell time using samples from patients on APD with 1- and 2-h dwell effluent within three months of PET and 4- and 10-h dwell effluent at PET.

Results: In total, 217 samples from 18 patients were included, with 63, 81, and 73 of the samples corresponding to the High [H], High-average [HA], and Low-average [LA] PET category, respectively. Sodium removal per UFV (g/L in salt equivalent) for dwell times of one, two, four, and ten hours was 5.2, 8.8, 8.0, and 11.5 for PET [H], 5.3, 5.8, 5.6, and 8.1 for PET [HA], and 4.6, 5.1, 5.1, and 7.1 for PET [LA], respectively.

Conclusions: Sodium removal per UFV in pediatric APD was less than the standard adult CAPD and tended to be lower with shorter dwell times, leading to sodium accumulation. Therefore, salt intake should be restricted in combination with one or more long daytime dwells, especially in anuric patients.

Keywords: Automated peritoneal dialysis; Dwell time; Na sieving; Peritoneal equilibrium test; Sodium removal.

PubMed Disclaimer

References

    1. Nakayama M, Kawaguchi Y, Water and Electrolyte Balance (WEB) Study Group in CAPD (2002) Multicenter survey on hydration status and control of blood pressure in Japanese CAPD patients. Perit Dial Int 22:411–414. https://doi.org/10.1177/089686080202200318 - DOI - PubMed
    1. Ploos van Amstel S, Noordzij M, Borzych-Duzalka D, Chesnaye NC, Xu H, Rees L, Ha IS, Antonio ZL, Hooman N, Wong W, Vondrak K, Yap YC, Patel H, Szczepanska M, Testa S, Galanti M, Kari JA, Samaille C, Bakkaloglu SA, Lai WM, Rojas LF, Diaz MS, Basu B, Neu A, Warady BA, Jager KJ, Schaefer F (2021) Mortality in Children Treated With Maintenance Peritoneal Dialysis: Findings From the International Pediatric Peritoneal Dialysis Network Registry. Am J Kidney Dis 78:380–390. https://doi.org/10.1053/j.ajkd.2020.11.031 - DOI - PubMed
    1. Ito Y, Ryuzaki M, Sugiyama H, Tomo T, Yamashita AC, Ishikawa Y, Ueda A, Kanazawa Y, Kanno Y, Itami N, Ito M, Kawanishi H, Nakayama M, Tsuruya K, Yokoi H, Fukasawa M, Terawaki H, Nishiyama K, Hataya H, Miura K, Hamada R, Nakakura H, Hattori M, Yuasa H, Nakamoto H (2021) Peritoneal Dialysis Guidelines 2019 Part 1 (Position paper of Japanese Society of Dialysis Therapy). Ren Replace Ther 7:40. https://doi.org/10.1186/s41100-021-00348-6 - DOI
    1. Schaefer F, Borzych-Duzalka D, Azocar M, Munarriz RL, Sever L, Aksu N, Barbosa LS, Galan YS, Xu H, Coccia PA, Szabo A, Wong W, Salim R, Vidal E, Pottoore S, Warady BA, IPPN investigators (2012) Impact of global economic disparities on practices and outcomes of chronic peritoneal dialysis in children: insights from the International Pediatric Peritoneal Dialysis Network Registry. Perit Dial Int 32:399–409. https://doi.org/10.3747/pdi.2012.00126 - DOI - PubMed - PMC
    1. Krediet RT, Lindholm B, Rippe B (2000) Pathophysiology of peritoneal membrane failure. Perit Dial Int 20(Suppl 4):S22-42. https://doi.org/10.1177/089686080002004S03 - DOI - PubMed

LinkOut - more resources