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Novel Method for Osmotic Conductance to Glucose in Peritoneal Dialysis

Martus, Giedre LU orcid ; Bergling, Karin LU ; Simonsen, Ole LU ; Goffin, Eric ; Morelle, Johann and Öberg, Carl M. LU (2020) In Kidney International Reports 5(11). p.1974-1981
Abstract

Introduction: The osmotic conductance to glucose (OCG) is a crucial determinant of ultrafiltration (UF) in peritoneal dialysis (PD) patients and can be used to monitor membrane integrity in patients on long-term PD. It has been proposed that OCG can be assessed based on drained volumes in 2 consecutive 1-hour glucose dwells, usually 1.5% and 4.25% glucose, in a so-called double mini-peritoneal equilibration test (dm-PET). However, recent data indicated that the dm-PET provides a poor estimate of OCG unless the residual volume (RV) is taken into account. We introduce an easy, robust, and accurate method to measure OCG and compare it with conventional methods. Methods: In a prospective cohort of 21 PD patients, a modified version of the... (More)

Introduction: The osmotic conductance to glucose (OCG) is a crucial determinant of ultrafiltration (UF) in peritoneal dialysis (PD) patients and can be used to monitor membrane integrity in patients on long-term PD. It has been proposed that OCG can be assessed based on drained volumes in 2 consecutive 1-hour glucose dwells, usually 1.5% and 4.25% glucose, in a so-called double mini-peritoneal equilibration test (dm-PET). However, recent data indicated that the dm-PET provides a poor estimate of OCG unless the residual volume (RV) is taken into account. We introduce an easy, robust, and accurate method to measure OCG and compare it with conventional methods. Methods: In a prospective cohort of 21 PD patients, a modified version of the dm-PET was performed, along with the determination of RV before, between, and after dwells. Based on computer simulations derived from the 3-pore model (TPM) for membrane permeability, we developed and validated a novel single-dwell method to estimate OCG. We next validated the equation in an independent cohort consisting of 32 PD patients. Results: Single-dwell OCG correlated more closely with actual UF (r = 0.94 vs. r = 0.07 for conventional dm-PET), sodium sieving, and free water transport (FWT) compared with other methods. These findings were replicated in the validation cohort in which OCG calculated using the single-dwell method closely correlated with parameters of osmotic water transport, even when RV was not taken into account, using only drained volumes. Conclusion: We propose a novel, easy, and robust single-dwell method to determine OCG in individual patients and to monitor membrane integrity over time on PD.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
osmotic conductance, osmotic water transport, peritoneal dialysis, peritoneal equilibration test, ultrafiltration
in
Kidney International Reports
volume
5
issue
11
pages
8 pages
publisher
Elsevier
external identifiers
  • pmid:33163718
  • scopus:85092935463
ISSN
2468-0249
DOI
10.1016/j.ekir.2020.09.003
language
English
LU publication?
yes
id
c8780707-e801-48f2-b7d8-90a1031bb3fd
date added to LUP
2020-11-11 13:57:19
date last changed
2024-04-03 14:59:30
@article{c8780707-e801-48f2-b7d8-90a1031bb3fd,
  abstract     = {{<p>Introduction: The osmotic conductance to glucose (OCG) is a crucial determinant of ultrafiltration (UF) in peritoneal dialysis (PD) patients and can be used to monitor membrane integrity in patients on long-term PD. It has been proposed that OCG can be assessed based on drained volumes in 2 consecutive 1-hour glucose dwells, usually 1.5% and 4.25% glucose, in a so-called double mini-peritoneal equilibration test (dm-PET). However, recent data indicated that the dm-PET provides a poor estimate of OCG unless the residual volume (RV) is taken into account. We introduce an easy, robust, and accurate method to measure OCG and compare it with conventional methods. Methods: In a prospective cohort of 21 PD patients, a modified version of the dm-PET was performed, along with the determination of RV before, between, and after dwells. Based on computer simulations derived from the 3-pore model (TPM) for membrane permeability, we developed and validated a novel single-dwell method to estimate OCG. We next validated the equation in an independent cohort consisting of 32 PD patients. Results: Single-dwell OCG correlated more closely with actual UF (r = 0.94 vs. r = 0.07 for conventional dm-PET), sodium sieving, and free water transport (FWT) compared with other methods. These findings were replicated in the validation cohort in which OCG calculated using the single-dwell method closely correlated with parameters of osmotic water transport, even when RV was not taken into account, using only drained volumes. Conclusion: We propose a novel, easy, and robust single-dwell method to determine OCG in individual patients and to monitor membrane integrity over time on PD.</p>}},
  author       = {{Martus, Giedre and Bergling, Karin and Simonsen, Ole and Goffin, Eric and Morelle, Johann and Öberg, Carl M.}},
  issn         = {{2468-0249}},
  keywords     = {{osmotic conductance; osmotic water transport; peritoneal dialysis; peritoneal equilibration test; ultrafiltration}},
  language     = {{eng}},
  number       = {{11}},
  pages        = {{1974--1981}},
  publisher    = {{Elsevier}},
  series       = {{Kidney International Reports}},
  title        = {{Novel Method for Osmotic Conductance to Glucose in Peritoneal Dialysis}},
  url          = {{http://dx.doi.org/10.1016/j.ekir.2020.09.003}},
  doi          = {{10.1016/j.ekir.2020.09.003}},
  volume       = {{5}},
  year         = {{2020}},
}