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Comparison of peritoneal equilibration test with 99mTc-DTPA excretion in the assessment of peritoneal permeability

  • B. K. DasEmail author
  • M. S. Senthilnathan
  • P. K. Pradhan
  • S. Nagabhushan
  • T. K. Jeloka
  • R. K. Sharma
Short Communication

Abstract

Assessment of peritoneal permeability is necessary for successful management of end-stage renal disease (ESRD) patients by continuous ambulatory peritoneal dialysis (CAPD). The objective of this study was to develop an alternative method of assessing the peritoneal permeability and to compare this method with the conventional method, the peritoneal equilibrium test, first described by Twardowski in 1987. Twenty patients undergoing regular CAPD were included in this study. Before starting the peritoneal dialysis, 370 MBq (10 mCi) technetium-99m diethylene triamine penta-acetic acid (99mTc-DTPA) was injected intravenously. A standard dose of the same quantity was kept and used later for calculations. At the end of 4 h, a dialysate fluid sample (1 ml) was collected and the total dialysis effluent fluid volume was measured. Excretion of 99mTc-DTPA into the dialysate fluid as a percentage of the injected dose was calculated. Simultaneously, standard peritoneal equilibrium test values were recorded for comparison. Peritoneal excretion of 99mTc-DTPA ranged from 8% to 25% of the injected dose, depending on the peritoneal membrane permeability. When the results were compared with the conventional method, a good correlation (r=0.79) was found. This innovative radionuclide technique is a simple and convenient method to assess the peritoneal membrane permeability and can be used as an alternative to the peritoneal equilibrium test, which is very cumbersome and associated with many limitations.

Keywords

Continuous ambulatory peritoneal dialysis Peritoneal equilibration test 99mTc-DTPA Peritoneal membrane permeability 

References

  1. 1.
    Popovich RP, Moncrief JW, Nolph KD, et al. Continuous ambulatory peritoneal dialysis. Ann Intern Med 1978; 88:449–456.PubMedGoogle Scholar
  2. 2.
    Twardowski ZJ, Nolph KD, Khanna R, et al. Peritoneal equilibration test. Perit Dial Bull 1987; 7:138.Google Scholar
  3. 3.
    Twardowski ZJ. Clinical value of standardized equilibrium tests in CAPD patients. Blood Purif 1989; 7:95–108.PubMedGoogle Scholar
  4. 4.
    Prasad N, Gupta A, Prasad KN, Sharma RK, et al. Microbiological trend in CAPD related peritonitis – a single center experience. Vth Annual Conference of Peritoneal Society of India. Abstract issue, 2–3.Google Scholar
  5. 5.
    Nolph KD, Miller F, Rubin J, Popovich R. New directions in peritoneal dialysis concepts and applications. Kidney Int 1980; 18 (Suppl):S111–S118.Google Scholar
  6. 6.
    Westman J. Baxter worldwide overview. Deerfield, IL: Baxter Healthcare, 1995.Google Scholar
  7. 7.
    Diaz-Buxo JA. Clinical use of peritoneal dialysis. In: Nissenson AR, Fine RN, Gentile DE, eds. Clinical dialysis, 3rd edn. Norwalk, CT: Appleton and Lange; 1995:376–425.Google Scholar
  8. 8.
    Goteh FA, Keen ML. Kinetic modeling in peritoneal dialysis. In: Nissenson AR, Fine RN, Gentile DE, eds. Clinical dialysis, 3rd edn. Norwalk, CT: Appleton and Lange; 1995:343–375.Google Scholar
  9. 9.
    Burkart JM, Jordan JR, Rocco M, et al. Assessment of dialysis adequacy by measured clearance versus extrapolated PET data. Perit Dial Int 1993; 13:184.PubMedGoogle Scholar
  10. 10.
    Trivedi H, Khanna R, Lo WK, Prowant BF, Nolph KD. Reproducibility of PET in CAPD patients. ASAIO J 1995; 40:M892–M895.Google Scholar
  11. 11.
    Maiorca R, Cantaluppi A, Cancarini GC, et al. Prospective controlled trial of a Y-connector and disinfectant to prevent peritonitis in continuous ambulatory peritoneal dialysis. Lancet 1983; 2:642–645.CrossRefPubMedGoogle Scholar
  12. 12.
    Mehrotra R, Khanna R, Yang TC, et al. Calculation of 6 hr D/P creatinine ratio from the 4-hour peritoneal equilibration test. The effect of dwell duration on the results. Perit Dial Int 1997; 17:273–278.PubMedGoogle Scholar
  13. 13.
    Margenstern MZ, Pyle WK, Gruskin AB, et al. Transport characteristics of paediatric peritoneal membrane. Kidney Int 1989; 25:259.Google Scholar
  14. 14.
    Nolph KD, Mactier R, Khanna R, et al. The kinetics of ultrafiltration during peritoneal dialysis. The role of lymphatics. Kidney Int 1987; 32:219–226.PubMedGoogle Scholar
  15. 15.
    Buoncristiani N, Altieri P, Cairo G, Quintialiani G, et al. Suitability of CAPD for long term uremic diabetics. Perit Dial Bull 1987; Suppl 7(2):S11.Google Scholar
  16. 16.
    Toubert ME, Michel C, Metivier F, et al. I-131 ablation therapy in a patient receiving peritoneal dialysis. Clin Nucl Med 2001; 26:302–305.CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • B. K. Das
    • 1
    Email author
  • M. S. Senthilnathan
    • 1
  • P. K. Pradhan
    • 1
  • S. Nagabhushan
    • 1
  • T. K. Jeloka
    • 2
  • R. K. Sharma
    • 2
  1. 1.Department of Nuclear MedicineSanjay Gandhi Postgraduate Institute of Medical SciencesLucknowIndia
  2. 2.Department of NephrologySanjay Gandhi Postgraduate Institute of Medical SciencesLucknowIndia

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