Discrepancy between weekly KT/V and weekly creatinine clearance in patients on CAPD. 1995

H H Chen, and A Shetty, and I E Afthentopoulos, and D G Oreopoulos
Division of Nephrology, Mackay Memorial Hospital, Taipei, Taiwan, Republic of China.

Currently, weekly KT/V and weekly creatinine clearance (WCC) are used to quantitate continuous ambulatory peritoneal dialysis (CAPD), the minimum recommended requirements being 1.7/week and 50 L/week, respectively. There is no substantial evidence that one index is better than the other, and there is no clear recommendation what one should do if there is a discrepancy between these two values. We performed a cross sectional analysis of 68 patients in whom we measured weekly KT/V, WCC, residual clearances, and a 4-hr peritoneal equilibration test (PET). The correlation between KT/V and WCC in the whole group was highly significant (p < 0.0001); when patients were divided in the four PET groups, there was a significant correlation (p < 0.05) in the low-average (n = 22) and high-average (n = 21) PET groups, but the correlation was not significant in the high (n = 13) and low (n = 12) PET groups. Fourteen of 68 patients (20%) showed a discrepancy between KT/V and WCC: 7 patients had a KT/V < 1.7 and WCC > or = 50 (group 1), and 7 patients had a KT/V > or = 1.7 and WCC < 50 (group 2). Those in group 1 with a WCC > 50 had a higher residual renal function (0.82 vs 0.11 mL/min, p < 0.05) than those in group 2 and therefore had a higher tubular secretion of creatinine and reabsorption of urea. Those in group 2 with a KT/V > 1.7 had lower creatinine equilibration than those in group 1 (D/Pcr 0.56 vs 0.75, p < 0.05) and therefore a better removal of urea than creatinine.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010531 Peritoneal Dialysis, Continuous Ambulatory Portable peritoneal dialysis using the continuous (24 hours a day, 7 days a week) presence of peritoneal dialysis solution in the peritoneal cavity except for periods of drainage and instillation of fresh solution. CAPD,Continuous Ambulatory Peritoneal Dialysis
D010537 Peritoneum A membrane of squamous EPITHELIAL CELLS, the mesothelial cells, covered by apical MICROVILLI that allow rapid absorption of fluid and particles in the PERITONEAL CAVITY. The peritoneum is divided into parietal and visceral components. The parietal peritoneum covers the inside of the ABDOMINAL WALL. The visceral peritoneum covers the intraperitoneal organs. The double-layered peritoneum forms the MESENTERY that suspends these organs from the abdominal wall. Parietal Peritoneum,Peritoneum, Parietal,Peritoneum, Visceral,Visceral Peritoneum,Parametrium,Parametriums
D010539 Permeability Property of membranes and other structures to permit passage of light, heat, gases, liquids, metabolites, and mineral ions. Permeabilities
D003404 Creatinine Creatinine Sulfate Salt,Krebiozen,Salt, Creatinine Sulfate,Sulfate Salt, Creatinine
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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