Journal - Nephrology Dialysis Transplantation

Abstract :

Peritoneal clearances and dialysate protein losses occurringin paediatric patients undergoing different continuous cyclingperitoneal dialysis (CCPD) regimens have not been well defined.We, therefore, evaluated 10 children aged 15.8±2.5 (SD)years who were maintained on home peritoneal dialysis for 20.5±10months. All patients had at least 3 months of CCPD. The patientswere admitted to the Clinical Research Center for 48 hours andallocated to five different dialysis protocols. In protocolI, the frequency of exchanges was 10 per 10 hours; in ProtocolII it was 5 per 10 hours; and in Protocol III it was 3 per 10hours. Protocol II D and III D had, in addition, a daytime dwellof one-half the night-time vol ume. A 1.5% glucose dialysatesolution was used for night-time dialysis, and 4.25% glucosedialysate solution for the daytime dwell. The mean inflow dialysatevolume per exchange was 36.7±5.6 ml/kg body weight andwas constant in each patient for each study protocol. BUN andcreatinine clearances for each protocol were calculated anddialysate protein losses were measured. The data indicate thathourly night-time dialysis (Protocol I) provides best soluteclearance. A daytime dwell further enhances the total soluteclearance and should be used preferably in anuric patients.Residual urine output contributes significantly to the totalsolute clearance. Protein losses are maximum with low-frequencyexchanges and a daytime dwell. No significant differences inthe serum albumin concentrations were found during the differentprotocols; however, the long-term effect of the protein losson the nutritional status of the patients requires further evaluation.