Adverse effect of peritonitis on peritoneal membrane function in children on dialysis

Sharon Andreoli, Jeffrey Leiser, Bradley A. Warady, Linda Schlichting, Eileen D. Brewer, Sandra L. Watkins

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

The effect of peritonitis on peritoneal membrane solute transport characteristics was determined as part of a multicenter study in children on continuous ambulatory/cycling peritoneal dialysis. Ninety-three children each underwent a 4-h peritoneal equilibration test (PET) with 1100 ml/m2 2.5% Dianeal for determination of mass transfer area coefficients (MTAC), dialysate to plasma ratios (D/P) for creatinine and urea at 0, 30, 60, 120, 180, and 240 min and dialysate glucose levels at 0, 30, 60, 120, 180, and 240 min for calculation of D/Do. The mean age of the study cohort was 10.1 ± 5.6 years (range 0.1-19 years). There were 162 historical episodes of peritonitis; at the time of the PET tests, 36 children had never had an episode of peritonitis (group I) while 57 children had a history of one or more episodes of peritonitis (group II). In group II children, the 4-h glucose D/Do was significantly lower and the 4-h D/P creatinine ratio, the creatinine MTAC, and the glucose MTAC were significantly higher (each P < 0.05) than in group I. In children with a history of peritonitis caused by Gram-negative organisms, the 4-h glucose D/Do (P < 0.05) and the creatinine MTAC (P < 0.05) were significantly lower and the glucose MTAC (P = 0.07) nearly significantly lower than in children without a history of peritonitis. Linear regression analysis did not demonstrate a correlation between any of the variables and duration of peritoneal dialysis, while the rate of peritonitis was weakly correlated with glucose MTAC (r = 0.34, P < 0.05) and with 4-h glucose D/Do (r = -0.222, P < 0.01). We conclude that children with a history of peritonitis have peritoneal membranes that are more permeable to glucose and creatinine than children without a history of peritonitis, and that the peritoneal membranes of children who have had peritonitis caused by Gram-negative organisms are also more permeable to creatinine and glucose. Such changes are likely to have an adverse effect on membrane function and could eventually contribute to ultrafiltration failure.

Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalPediatric Nephrology
Volume13
Issue number1
DOIs
StatePublished - Jan 1999

Fingerprint

Peritonitis
Dialysis
Membranes
Glucose
Creatinine
Dialysis Solutions
Continuous Ambulatory Peritoneal Dialysis
Ultrafiltration
Peritoneal Dialysis
Multicenter Studies
Urea
Linear Models
Cohort Studies
Regression Analysis

Keywords

  • Dialysis
  • Peritoneal membrane function
  • Peritonitis

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

Cite this

Adverse effect of peritonitis on peritoneal membrane function in children on dialysis. / Andreoli, Sharon; Leiser, Jeffrey; Warady, Bradley A.; Schlichting, Linda; Brewer, Eileen D.; Watkins, Sandra L.

In: Pediatric Nephrology, Vol. 13, No. 1, 01.1999, p. 1-6.

Research output: Contribution to journalArticle

Andreoli, S, Leiser, J, Warady, BA, Schlichting, L, Brewer, ED & Watkins, SL 1999, 'Adverse effect of peritonitis on peritoneal membrane function in children on dialysis', Pediatric Nephrology, vol. 13, no. 1, pp. 1-6. https://doi.org/10.1007/s004670050553
Andreoli, Sharon ; Leiser, Jeffrey ; Warady, Bradley A. ; Schlichting, Linda ; Brewer, Eileen D. ; Watkins, Sandra L. / Adverse effect of peritonitis on peritoneal membrane function in children on dialysis. In: Pediatric Nephrology. 1999 ; Vol. 13, No. 1. pp. 1-6.
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N2 - The effect of peritonitis on peritoneal membrane solute transport characteristics was determined as part of a multicenter study in children on continuous ambulatory/cycling peritoneal dialysis. Ninety-three children each underwent a 4-h peritoneal equilibration test (PET) with 1100 ml/m2 2.5% Dianeal for determination of mass transfer area coefficients (MTAC), dialysate to plasma ratios (D/P) for creatinine and urea at 0, 30, 60, 120, 180, and 240 min and dialysate glucose levels at 0, 30, 60, 120, 180, and 240 min for calculation of D/Do. The mean age of the study cohort was 10.1 ± 5.6 years (range 0.1-19 years). There were 162 historical episodes of peritonitis; at the time of the PET tests, 36 children had never had an episode of peritonitis (group I) while 57 children had a history of one or more episodes of peritonitis (group II). In group II children, the 4-h glucose D/Do was significantly lower and the 4-h D/P creatinine ratio, the creatinine MTAC, and the glucose MTAC were significantly higher (each P < 0.05) than in group I. In children with a history of peritonitis caused by Gram-negative organisms, the 4-h glucose D/Do (P < 0.05) and the creatinine MTAC (P < 0.05) were significantly lower and the glucose MTAC (P = 0.07) nearly significantly lower than in children without a history of peritonitis. Linear regression analysis did not demonstrate a correlation between any of the variables and duration of peritoneal dialysis, while the rate of peritonitis was weakly correlated with glucose MTAC (r = 0.34, P < 0.05) and with 4-h glucose D/Do (r = -0.222, P < 0.01). We conclude that children with a history of peritonitis have peritoneal membranes that are more permeable to glucose and creatinine than children without a history of peritonitis, and that the peritoneal membranes of children who have had peritonitis caused by Gram-negative organisms are also more permeable to creatinine and glucose. Such changes are likely to have an adverse effect on membrane function and could eventually contribute to ultrafiltration failure.

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