Abstract: PUB197
Concordance between Dialysate-to-Plasma (D/P) Ratios for Urea and Creatinine in Peritoneal Equilibration Testing: A Retrospective Observational Cohort Study
Session Information
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Chatragadda, Lohith S., University of Rhode Island, Kingston, Rhode Island, United States
- Hu, Susie L., Brown University Warren Alpert Medical School, Providence, Rhode Island, United States
- Shah, Ankur, Brown University Warren Alpert Medical School, Providence, Rhode Island, United States
Background
Peritoneal equilibration testing (PET) is a crucial tool for assessing peritoneal membrane function in patients undergoing peritoneal dialysis (PD). The dialysate-to-plasma (D/P) ratios of urea and creatinine are commonly used to evaluate peritoneal transport characteristics. This study aimed to assess the concordance between D/P Glucose and D/P creatinine in PET and identify factors associated with discordance.
Methods
A retrospective observational cohort study was conducted using data from PD patients who underwent PET between 1/1/2015 and 12/31/2021 at a single PD center. Demographic, clinical, and PET data were collected from electronic medical records. Concordance between D/P urea and D/P creatinine was assessed using the spearman rank correlation coefficient.
Results
A total of 67 PD patients (mean age: 54.5±2.1 years; 40.3% male) were included in the study. The mean 4 hour D/P glucose and D/P creatinine were 0.78±0.02 and 0.37±0.05, respectively. Spearmans rho between 2h and 4h Glucose was .9058 and Spearmans rho between 2h and 4h Creatinine was .8713. Discordance between 4h glucose and 4h creatinine was observed in 20 (29.8%) patients. Spearmans rho between D/P glucose and D/P creatinine was 0.79. In discordant pairs, 4h creatinine was better correlated than 4h glucose with 4h UF (rho .23 vs .19).
Conclusion
In this retrospective observational cohort study, we found a strong correlation between D/P glucose and D/P creatinine in peritoneal equilibration testing (PET) among peritoneal dialysis (PD) patients. The high Spearman's rho values between the 2-hour and 4-hour measurements for both glucose and creatinine suggest that these markers provide consistent information about peritoneal transport characteristics over time.
However, discordance between 4-hour D/P glucose and 4-hour D/P creatinine was observed in nearly 30% of patients. This finding highlights the potential limitations of relying on a single marker to assess peritoneal membrane function. In cases of discordance, 4-hour D/P creatinine showed a slightly stronger correlation with 4-hour ultrafiltration compared to 4-hour D/P glucose, suggesting that creatinine may be a more reliable indicator of peritoneal transport when the two markers are discordant.