Peritoneal membrane phosphate transport status: A cornerstone in phosphate handling in peritoneal dialysis
Entity
UAM. Departamento de MedicinaPublisher
American Society of NephrologyDate
2011-03-01Citation
10.2215/CJN.06960810
Clinical Journal of the American Society of Nephrology 6 (2011): 591-597
ISSN
1555-9041 (print); 1555-905X (online)DOI
10.2215/CJN.06960810Funded by
This study has been performed partially with the help of Instituto de Salud Carlos III and Fondos FEDER (REDinREN, RETICS 06/0016) and FIS 09/00641 to R.S.Editor's Version
http://dx.doi.org/10.2215/CJN.06960810Subjects
Hyperphosphatemic; Peritoneal membrane; Dialysis; MedicinaRights
© 2011 by the American Society of NephrologyAbstract
Background and objectives Phosphate control impacts dialysis outcomes. Our aim was to define peritoneal
phosphate transport in peritoneal dialysis (PD) and to explore its association with hyperphosphatemia,
phosphate clearance (PPhCl), and PD modality.
Design, setting, participants, & measurements Two hundred sixty-four patients (61% on continuous ambulatory
PD [CAPD]) were evaluated at month 12. PPhCl was calculated from 24-hour peritoneal effluent. Phosphate
(Ph) and creatinine (Cr) dialysate/plasma (D/P) were calculated at a 4-hour 3.86% peritoneal equilibration
test.
Results D/PPh correlated with D/PCr. PPhCl correlated better with D/PPh than with D/PCr. Prevalence of
hyperphosphatemia ( 5.5 mg/dl) was 30%. In a multiple regression analysis, only residual renal function
was independently, negatively associated with hyperphosphatemia; in anuric patients, only D/PPh was an
independent factor predicting hyperphosphatemia. D/PPh was 0.57 0.10, and according to this, 16% of
the patients were fast, 31% were fast-average, 35% were slow-average, and 17% were slow transporters.
PPhCl was 37.5 11.7 L/wk; it was lower in the slow transporter group (31 14 L/wk). Among fast and
fast-average transporters, PPhCl was comparable in both PD modalities. In comparison to automated PD,
CAPD was associated with increased PPhCl among slow-average (36 8 versus 32 7 L/wk) and slow
transporters (34 15 versus 24 9 L/wk).
Conclusions In hyperphosphatemic, particularly anuric, patients, optimal PD modality should consider peritoneal
phosphate transport characteristics. Increasing dwell times and transfer to CAPD are effective strategies
to improve phosphate handling in patients with inadequate phosphate control on automated PD.
Files in this item
Google Scholar:Bernardo, Ana Paula
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Contesse, Sebastián Azorin
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Bajo Rubio, María Auxiliadora
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Rodrigues, Anabela S.
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Del Peso, Gloria D.
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Ossorio, Marta
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Cabrita, António N.
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Selgas Gutiérrez, Rafael
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