Dissociation between Clearances of Small and Middle Molecules in Incremental Peritoneal Dialysis / 대한신장학회잡지

OBJEVTIVE: To evaluate the peritoneal clearance of the middle molecule compared with that of the small molecule in incremental peritoneal dialysis(PD). METHODS: Peritoneal clearances of the creatinine and beta2-microgloblulin were compared in 57 continuous ambulatory PD patients with full dose 4 times exchange and in 54 incremental PD patients with 2 or 3 times exchange over 24 hours. The clearances were also compared when there were changes in the peritoneal dialysis regimen such as in the number of exchanges and dwelling time. RESULTS: Peritoneal creatinine clearance increased almost linearly along with the increase in the number of exchanges. In contrast, peritoneal clearance of beta2-microglobulin was 9.1+/-3.6 L/week, 8.8+/-4.4 L/ week, and 7.9+/-2.5 L/week respectively with 2, 3 and 4 exchanges per day, not different from each other. Peritoneal clearance of beta2-microglobulin did not change when there was an increase in the number of exchange from 2 to 3 times and 3 to 4 times over a period of 24 hours, whereas the peritoneal clearance of creatinine increased. Peritoneal clearance of beta2-microglobulin almost doubled from 5.4+/-2.7 L/ week with 2 times exchange over 12 hours per day, to 9.5+/-4.4 L/week with 2 times exchange over 24 hours, whereas the creatinine clearance did not change. CONCLUSION: In contrast to peritoneal clearance of small molecule which depends on the number of dialysate exchange, peritoneal clearance of middle molecule depends mainly on the total dwelling hours rather than the number of exchange per day in incremental PD. This can be another advantage of incremental PD since peritoneal clearance of middle molecules in incremental PD over 24 hours is comparable to that in full dose PD.

Eearly impact of incremental peritoneal dialysis / 中国实用内科杂志

Objective To investigate the early impact of incremental peritoneal dialysis.Methods 109 new peritoneal dialysis patients treated with incremental peritoneal dialysis were included in the present study.Clinical data,dialysis adequacy and nutritional status were evaluated at the initiation of dialysis and at 3 months after PD.Results The peritoneal dialysis patients achieved good results in the dialysis adequacy and nutrition at the end of the 3rd month.The patients' comorbidities reduced.BP and blood work improved significantly during the first 3 months.Conclusion Our results suggest that incremental PD improve patients clinical status even at the early stage of dialysis.