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Abstract: FR-PO495

Successful Measurement of Intraperitoneal Pressure (IPP) in Peritoneal Dialysis Patients With a Pressure Transducer Demonstrates Significant Interindividual Variation and a Complex Relationship With IP Volume

Session Information

Category: Dialysis

  • 702 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Uribarri, Jaime, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Aslam, Nabeel, Mayo Clinic Florida, Jacksonville, Florida, United States
  • Sharma, Shuchita, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Billah, Marzuq M., Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Wilmington, Alyssa, Baxter International Inc, Deerfield, Illinois, United States
  • Keller, Brad, Baxter International Inc, Deerfield, Illinois, United States
  • Muller, Matthew R., Baxter International Inc, Deerfield, Illinois, United States
  • Rutherford, Peter, Baxter International Inc, Deerfield, Illinois, United States
Background

High IPP has been linked to abdominal fullness, mechanical complications and reduced ultrafiltration. Studying IPP is limited by the cumbersome manual fluid manometry method. A device making IPP measurement easier to conduct regularly may assist clinicians to adjust prescribed fill volumes (V). This study determined whether pressure-transducer IPP measurement is related to manual IPP measurement and fill volume

Methods

IPP measured by a commercially-available transducer was compared to IPP measured simultaneously by fluid manometry in a PD disposable set in 10 APD patients over 3 replicate fill cycles. IPP was measured after the drain, after 750ml fill volume and after 5 additional equidistant increments [(prescribed fill volume - 750ml)/5] up to the individual’s prescribed fill volume

Results

There was moderate overall agreement between transducer and manual IPP measurements (±3 cm H2O, Figure 1), with no systematic biases observed across the range of measured IPP. Large inter-patient variability in IPP was observed; at 750 ml of fill volume, IPP varied from 4-20 cm H20. There was a lack of correlation between the transducer derived IPP and fill volume among the patients (Spearman correlation coefficient 0.2). All 10 patients showed a significant relationship between IPP and IPV at an individual level, but with significant inter-patient variation in slope and intercept of the best fit line. A potential joint relationship between IPP, IPV and patient weight was observed

Conclusion

IPP can be measured with a pressure transducer, results are similar to the manual method but is easier to perform. IPP is highly variable across individuals and has complex relationships with fill volume in individual patients meriting further study to determine the clinical utility of IPP measurement

Funding

  • Commercial Support – Baxter