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Physiology of High/Fast Transporters

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Nolph and Gokal's Textbook of Peritoneal Dialysis

Patients on peritoneal dialysis have large interindividual differences in the velocity of solute equilibration between plasma and the dialysate [1]. In an attempt to standardize assessment of this variability, Twardowski et al. developed the peritoneal equilibration test (PET) [2]. In the PET solute transport after a standardized dwell of 4 h is expressed as the dialyse/plasma (D/P) concentration ratio of various solutes. D/P creatinine had a mean value of 0.65, but it ranged from 0.34 to 1.03 [3]. A similar range was reported in another study using the PET [4]. Based on D/P creatinine, patients have been divided into four transport categories: low, low average, high average, and high [3]. This categorization was based on the mean value and the standard deviation (SD). Low is less than 1 SD, low average is between the mean and –1 SD, low average is between the mean and +1 SD, and high is above 1 SD. The cut-off levels are: <0.50 for low, 0.50–0.65 for low average, 0.65–0.81 for high average, and >0.81 for high transporters. About 10% of prevalent PD patients can be classified as high transporters [5].

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  1. Academic Medical Center University of Amsterdam, Amsterdam, The Netherlands

    R. T. Krediet

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  1. School of Medicine Department of Medicine Division of Nephrology, MA436 Health Sciences Center, Columbia, MO 65212, USA

    Ramesh Khanna

  2. Academic Medical Center Dept. Medicine, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands

    Raymond T. Krediet

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Krediet, R.T. (2009). Physiology of High/Fast Transporters. In: Khanna, R., Krediet, R.T. (eds) Nolph and Gokal's Textbook of Peritoneal Dialysis. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-78940-8_7

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