Standard peritoneal permeability analysis in PD children

Introduction: In CAPD patients the peritoneal transport characteristics can be assessed by the standard peritoneal permeability analysis (SPA), a modification of the peritoneal equilibration lest (PET). Fluid kinetics, mass transfer area coefficients (MTACs) of low molecular weight solutes and protein clearances are determined. In contrast to adult CAPD patients no information of SPA is known in PD children. Patients and Methods: 31 SPAs were performed in 18 PD children with a mean age of 10 years (range 2-19) and a mean duration of PD of 2.8 years (range 0.19-6.8) The test used a 4 hours dwell (average volume 1170 ml./ m²) glucose 1.36 % to which dextran 70 (1 g/l) is added. Results: Fluid Parameters; the median (range) transcapillary ultrafiltration rate was 1.2 (-0.01 to 2.8) ml./min./1.73 m², the net Ultrafiltration rate 0.2 (-1.97 to 1.82) and the lymphatic absorption rate 1.04 (0.06 to 2.91). MTACs (Waniewski); the median (range) MTAC for creatinine was 9.6 (4.4-18.0) ml./min./1.73 m², for urea 17.3 (12.2-22.8) and for unite 7.1 (3.3-14.1). Protein clearances; the median (range) clearance of β2microglobulin was 923 (366-1828) μ1./min./1.73 m², of albumin 103 (55-211), of IgG 48 (20-105) and of α2macroglobulin 12 (5-49). No correlation was found between these clearances and PD time. The restriction coefficient increased (r = 0.38, p = 0.03). Conclusion: When corrected for body surface area no differences were found in peritoneal fluid and solute transport characteristics between children and adults. No effect of time on PD on the transport parameters was found in a cross sectional analysis, except for an increase of the restriction coefficient to macromolecules, which is similar to observations in adults.