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Phosphate equilibration rate and daily clearance in patients on CAPD, CCPD and APD

Abstract

Background

Criteria for how to assess removal rate of inorganic phosphorous (iP) in peritoneal dialysis (PD) and whether iP removal differs between different PD modalities are debated.

Methods

In a cross-sectional study, 73 prevalent patients on continuous ambulatory PD (n = 16), continuous cyclic PD (n = 8) or automated PD (n = 49) with mean age 54 (range, 18-87) years, 46 males, underwent standard peritoneal equilibration test (PET) and 24-hour collection of dialysate with measurements of iP, urea and creatinine in all samples and bags. There were 11 slow, 53 average, and 9 fast transporters.

Results

D/P ratios for iP and creatinine at 4 h of PET were strongly correlated (ρ = 0.86, p<0.0001). Allocation of patients into slow, average and fast transporters according to D/P ratios for iP and creatinine was essentially similar. Whereas the weekly peritoneal clearance of iP (30.8 ± 16.6 L/wk) was lower than that of creatinine (38.4 ± 14.9 L/wk), clearances were strongly correlated (ρ = 0.89, p<0.0001). The correlation between peritoneal weekly clearance of iP and urea KT/V was however weak (ρ = 0.56, p<0.0001. CAPD patients had higher iP clearance than APD patients, 43.2 ± 14.9 versus 24.7 ± 13.4 L/wk (p<0.05); however, serum iP concentrations did not differ.

Conclusions

Creatinine is a good surrogate marker for phosphate removal, both as assessed by PET and by 24 hours’ clearance, in different PD modalities. Therefore, a separate PET scale for phosphate may not be needed. iP removal was greater with CAPD than APD but serum phosphate levels did not differ.

Int J Artif Organs 2016; 39(12): 596 - 602

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/ijao.5000547

Authors

Rafael Gomez, Jacek Waniewski, Adelaida Zapata, Mauro Pietribiasi, Bengt Lindholm

Article History

Disclosures

Financial support: Baxter Novum is the result of a grant from Baxter Healthcare to Karolinska Institutet.
Conflict of interest: Bengt Lindholm is employed by Baxter Healthcare. Rafael Gomez and Adelaida Zapata are employed by RTS, Colombia.

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Authors

Affiliations

  •  Renal Unit, RTS Versalles, Cali - Colombia
  •  Institute of Biocybernetics and Biomedical Engineering, Warsaw - Poland
  •  Baxter Novum and Renal Medicine, Karolinska Institutet, Stockholm - Sweden

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