- 期刊
- OpenAccess
A Modified Fast Peritoneal Equilibration Test
改良型快速腹膜平衡測試
摘要
Background: The peritoneal equilibration test (PET) is a good tool for evaluating the permeability of the peritoneum. However, the standard PET (sPET) is time-consuming. Because of limitations and unreliability of the fast peritoneal equilibration test (fast PET), we evaluated the new modified fast PET (mfPET). Methods: All patients first underwent the sPET and the initial drain dialysate (D0) samples for glucose measurement were obtained. At the 4(superscript th) hour of the dwell dialysate, the fast PET was performed, and both serum and drain dialysate were obtained from the patients. The mfPET was also performed according to the following procedure. After the fast PET, the abdomen dialysate was completely drained and the abdomen was infused using a new bag of 2.5% dextrose dialysate. Soon after mixing was completed in the peritoneum, the dialysate was drained for sampling to measure the glucose level (D(subscript n)) at 0 hour for comparison with the initial drain dialysate (D0) glucose of the sPET. The dialysate-to-plasma ration for creatinine (D/P Cr) at the 4th hour, the drain dialysate at the 4(superscript th) hourlinitial dialysate (D(subscript 4h/D0) glucose ratio, and the D(subscript 4h)/D(subscript n) glucose ratio were calculated and fitted into the category of each PET. Results: Fourteen continuous ambulatory peritoneal dialysis patients (7 men and 7 women; age ranging from 30 to 76 years) participated in the study. The glucose levels of Dn were well correlated with those of Do (r=0.846, P＜0.001). The correlation between the D(subscript 4h)/D(subscript n) glucose ratios and the D(subscript 4h)/D0 glucose ratios (r=0.992, P＜0.001) was better than that between the D(subscript 4h) glucose levels and the D(subscript 4h)/D0 glucose ratios (r=0.975, P＜0.001). With regard to agreement with sPET categories from the D(subscript 4h)/D0 glucose ratios, mfPET categories from the D(subscript 4h)/D(subscript n) glucose ratios were better than fast PET categories from the D(subscript 4h) glucose levels (weighted kappa, 0.92 vs. 0.80). With regard to agreement with the D/P Cr ratios, mfPET categories from the D(subscript 4h)/D(subscript n) glucose ratios were better than fast PET categories from the D(subscript 4h) glucose levels (weighted kappa, 0.65 vs. 0.45). Conclusions: The modified fast PET is more cost-effective than the standard PET and more reliable than the fast PET. Therefore, it can be used as a valid alternative procedure for follow-up of sPET.
並列摘要
Background: The peritoneal equilibration test (PET) is a good tool for evaluating the permeability of the peritoneum. However, the standard PET (sPET) is time-consuming. Because of limitations and unreliability of the fast peritoneal equilibration test (fast PET), we evaluated the new modified fast PET (mfPET). Methods: All patients first underwent the sPET and the initial drain dialysate (D0) samples for glucose measurement were obtained. At the 4(superscript th) hour of the dwell dialysate, the fast PET was performed, and both serum and drain dialysate were obtained from the patients. The mfPET was also performed according to the following procedure. After the fast PET, the abdomen dialysate was completely drained and the abdomen was infused using a new bag of 2.5% dextrose dialysate. Soon after mixing was completed in the peritoneum, the dialysate was drained for sampling to measure the glucose level (D(subscript n)) at 0 hour for comparison with the initial drain dialysate (D0) glucose of the sPET. The dialysate-to-plasma ration for creatinine (D/P Cr) at the 4th hour, the drain dialysate at the 4(superscript th) hourlinitial dialysate (D(subscript 4h/D0) glucose ratio, and the D(subscript 4h)/D(subscript n) glucose ratio were calculated and fitted into the category of each PET. Results: Fourteen continuous ambulatory peritoneal dialysis patients (7 men and 7 women; age ranging from 30 to 76 years) participated in the study. The glucose levels of Dn were well correlated with those of Do (r=0.846, P＜0.001). The correlation between the D(subscript 4h)/D(subscript n) glucose ratios and the D(subscript 4h)/D0 glucose ratios (r=0.992, P＜0.001) was better than that between the D(subscript 4h) glucose levels and the D(subscript 4h)/D0 glucose ratios (r=0.975, P＜0.001). With regard to agreement with sPET categories from the D(subscript 4h)/D0 glucose ratios, mfPET categories from the D(subscript 4h)/D(subscript n) glucose ratios were better than fast PET categories from the D(subscript 4h) glucose levels (weighted kappa, 0.92 vs. 0.80). With regard to agreement with the D/P Cr ratios, mfPET categories from the D(subscript 4h)/D(subscript n) glucose ratios were better than fast PET categories from the D(subscript 4h) glucose levels (weighted kappa, 0.65 vs. 0.45). Conclusions: The modified fast PET is more cost-effective than the standard PET and more reliable than the fast PET. Therefore, it can be used as a valid alternative procedure for follow-up of sPET.