Kidney Week

Abstract: FR-PO494

Consistency in Membrane Transport in Early and Later Peritoneal Equilibration Testing

Session Information

• Peritoneal Dialysis: Current Topics
  November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 702 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

• Smith, Paul E., Fresenius Kidney Care, Waltham, Massachusetts, United States

Paul E. Smith,

• Carver, Michelle, Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States

Michelle Carver,

• Rutzen, Christopher Richard, Fresenius Kidney Care, Waltham, Massachusetts, United States

Christopher Richard Rutzen,

• Ledoux, Sarah, Fresenius Kidney Care, Waltham, Massachusetts, United States

Sarah Ledoux,

• Draughon, Samantha, Fresenius Kidney Care, Waltham, Massachusetts, United States

Samantha Draughon,

• Davis, Angela L., Fresenius Kidney Care, Waltham, Massachusetts, United States

Angela L. Davis,

• Robideaux, Bridget R., Fresenius Kidney Care, Waltham, Massachusetts, United States

Bridget R. Robideaux,

• Johnson, Selma, Fresenius Kidney Care, Waltham, Massachusetts, United States

Selma Johnson,

• Willetts, Joanna, Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States

Joanna Willetts,

• Chaudhuri, Sheetal, Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States

Sheetal Chaudhuri,

• Larkin, John W., Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States

John W. Larkin,

• Chatoth, Dinesh K., Fresenius Kidney Care, Waltham, Massachusetts, United States

Dinesh K. Chatoth,

Group or Team Name

• The Early PET Group

Background

The peritoneal equilibration test (PET) has been recommended to be done 6-12 weeks after starting peritoneal dialysis (PD) (Morelle, Perit Dial Int 2021). The PET requires a special overnight pre-exchange process and 4-hour dwell in the clinic, which can be challenging for patients to complete. This can be seen by estimates suggesting >30% PD patients do not have a PET (Mehrotra, CJASN 2015). There is a lack of evidence defining optimal timing for the PET and it might be easier for patients to complete during PD training. We conducted a quality improvement pilot to evaluate if repeated PET results differ during training versus 6-12 weeks after PD start.

Methods

From Jan 2020 to Aug 2021, incident PD patients treated at a network of clinics could have a PET ordered during in-center training (typically the first 14 days of PD) and 6-12 weeks after PD start. The D/D0 glucose (ratio of dialysate glucose at 4 vs 0 hours) and D/P creatinine (ratio of dialysate vs plasma creatinine at 4 hours) was assessed between each patient’s two PET tests using correlation statistics and ANOVA.

Results

Forty-four PD patients from 32 clinics (mean age 55±13 years, 43% female, 50% Black race, 11% Hispanic ethnicity, and 61% with diabetes) had a PET during training and another repeated later (mean=52 days & median=47 days between PETs). There were strong correlations in D/D0 glucose (correlation coefficient=0.45, p<0.001, Figure 1A) and D/P creatinine (correlation coefficient=0.43, p<0.001, Figure 1B) between the PET during training versus 6-12 weeks after PD start.

Conclusion

We found the profiles of peritoneal membrane solute transport identified in the PET during training were significantly correlated to and representative of the membrane transport kinetics performed 6-12 weeks after initiation of PD. It appears the membrane transport characteristics are reasonably consistent throughout the first months of PD.

Funding

• Commercial Support – Fresenius Medical Care