Assessment of Peritoneal Membrane Transport Characteristics of indigenous South African Patients on Continuous Ambulatory Peritoneal Dialysis

Abstract

Background: Knowledge of peritoneal membrane transport characteristics is important for the prescription of appropriate peritoneal dialysis (PD) for individual patients. Peritoneal Equilibration Test (PET) has been widely used and validated among different population groups as an acceptable means of assessing peritoneal membrane characteristic, though not much has been reported on indigenous African PD populations.
Objectives: To assess the peritoneal membrane transport characteristics among CAPD patients at the Charlotte Maxeke Johannesburg hospital using PET and to compare with those reported in other populations, as well as its relationship with other variables.
Materials and methods: A cross-sectional study involving 80 patients with ESRD treated by Continuous Ambulatory Peritoneal Dialysis (CAPD). The PET was performed as described by Twardowsky et al. Glucose hexokinase method was used for the estimation of glucose while picric acid method was used for the measurement of creatinine in the dialysate.
Results: The mean age of the patients was 38 ± 12.43 years, 42.3% were females and 86% were blacks. Mean duration on PD was 19.8 ± 20.67
months. The means of the ratio of creatinine concentrations in the dialysate and plasma (D/P creatinine) at 4hours, and the ratio of glucose concentration at 4hours compare with time 0, (D/D0 glucose) were 0.74 ± 0.12 and 0.43 ± 0.16 respectively. Based on these, 18% of the patients studied were high transporters, 33.8% high average transporters, 36.9% low average transporters and 12% low transporters. There was a significant relationship between the D/P creatinine at 4 hours and the serum albumin while there was none with other variables such as the age of the patients, duration on PD, body mass index (BMI), body surface area (BSA) and the weekly Kt/V.
Conclusion: The percentage distribution of the different transporter types was similar to those previously reported in the literature. we found no relationship between the D/P creatinine at 4 hours with indices of PD adequacy such as the weekly Kt/ V while we found a significant relationship with serum albumin