MO710: Longitudinal Effects of Different Biocompatible Peritoneal Solutions on Membrane Function

BACKGROUND AND AIMS

Peritoneal biocompatible dialysates (low GDPs, neutral pH) seem to sustain more steady peritoneal membrane characteristics compared to conventional ones. However, various brand biocompatible dialysates have different composition (e.g. in lactate concentration) and there is no published study comparing their effects on membrane characteristics in long peritoneal dialysis (PD). Our PD unit has been using solely two brands of biocompatible dialysates (Balance, Fresenius© and Physioneal, Baxter©) since 2000. The aim of our study was to compare longitudinal data on peritoneal membrane function between these two different brand solutions

METHOD

Membrane characteristics were assessed by uni-peritoneal equilibration test (uni-PET, a combination of modified and mini PET), which is performed at least annually on every patient. Patients with no less than two PETs were included. We estimated dialysate to plasma (D/P) creatinine, ultrafiltration (UF) at 4 h, sodium seiving expressed as Dip/DPNa = [(dialysate sodium time 0/plasma sodium)–(dialysate sodium time 1 h/plasma sodium)], sodium removal (in 1 h) and free water transport (FWT). We collected clinical and lab data of the patients too.

RESULTS

A total of 85 patients (age 61.1 ± 15.1 years) were included—38 patients on Balance and 47 on Physioneal. The main characteristics of the patients are shown in Τable 1. Baseline membrane characteristics presented no differences between the two groups (D/Pcre 0.75 ± 0.125 versus 0.745 ± 0.11, P = 0.71—UF 660 ± 285 mL versus 651 ± 252 mL, P = 0.86—DipDPNA 0.05 ± 0.03 versus 0.047 ± 0.046 P = 0.54—sodium removal 30 (15.7, 42.3) mEq versus 38 (17.3, 46)mEq, P = 0.31—FWT 149 ± 85 mL versus 140 ± 109 mL, P = 0.69).

The patients were followed up for a median of 36 months (range 2.4–143). A total of 219 PETs were performed. Analysis for repeated PET tests was performed by using generalized linear regression models. The membrane characteristics (D/Pcre, Dip/DPNa, FWT and UF) of both groups remained stable longitudinally and overall no differences between the two different solutions were observed (Fig. 1). Only at the fourth year of follow-up, patients on Balance solutions had lower D/Pcre compared to Physioneal (0.62 versus 0.72, P = 0.003).

CONCLUSION

Different biocompatible solutions had no differences on peritoneal membrane characteristics longitudinally.