Comparison of peritoneal equilibration test with 2.27% and 3.86% glucose dialysis solution

BACKGROUND: The standard Peritoneal Equilibration Test (PET) uses a 2.27% glucose dialysis solution in peritoneal dialysis (PD). A more hypertonic solution (3.86%) has recently been proposed to obtain further information about ultrafiltration (UF). AIM: To compare results in terms of peritoneal solute transport (4h-dialysate-to-plasma ratio, 4h-D/P) between 2.27% and 3.86% PET. DESIGN: 23 patients on PD were randomized to form two groups, A and B. A 2.27% dextrose 2-L exchange was used in group A, followed on the same day by a 3.86% dextrose 2-L exchange, both with a 4-hour dwell (2.27% and 3.86% PET); in group B, the same treatment was administered in reverse. 4h-D/P of urea, creatinine and sodium at time 0, 60, 120 and 240 minutes and net UF were calculated for each PET and compared. RESULTS: No significant statistical differences were found for the usual peritoneal transport indexes, 4h-D/P of urea and creatinine, between 2.27% and 3.86% PET, which produced almost identical results. The creatinine 4h-D/P were 0.67+/-0.09 vs. 0.66+/-0.10 (p= NS) and the urea 4h-D/P 0.91+/-0.04 vs. 0.90+/-0.04 (p= NS). The sodium D/P was lower at all times during the 3.86% PET: D/P60= 0.92+/-0.05 vs. 0.88+/-0.03, D/P120= 0.91+/-0.02 vs. 0.87+/-0.03, D/P240= 0.92+/-0.02 vs. 0.88+/-0.04 (p< 0.0001). The net UF was 478 +/- 175 vs. 936 +/- 233 mL respectively (p< 0.0001). CONCLUSION: Our study suggests that a 3.86% PD solution could be used for PET instead of the 2.27% solution in order to assess peritoneal solute transport, as well as UF, while obtaining almost identical results as the 2.27% solution.