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Peritoneal dialysis (PD) is a treatment procedure for chronic kidney disease (CKD) that utilizes the patient's peritoneal membrane as a natural filter to remove waste products and excess fluids from the body, and it serves as a viable option for kidney replacement therapy (KRT). Effectively prescribing PD requires an understanding of individual characteristics of peritoneal membrane transport, evaluated through the peritoneal equilibration test (PET). Based on this test, the patient's peritoneum can be classified into four categories: high, high average, low average, or low peritoneal transport.
Despite abundant reviews on high transporters and automated PD (APD), limited attention has been given to low transporters in APD. This study aims to evaluate the clinical experiences and outcomes of patients with low or low average peritoneal transport in APD, focusing on clinical features, nutritional parameters, complications, and technique duration.
An observational, retrospective, and longitudinal study was conducted at the Peritoneal Dialysis Service within the Nephrology Department of the National Institute of Cardiology. Participants included individuals with CKD receiving APD and manifesting low and low average peritoneal transport, determined through PET.
The study included 48 patients, with 33 presenting low average peritoneal transport (LAPT) and 15 showing low peritoneal transport (LPT). Mean ages were 39 ± 2.53 years for those with LAPT and 36.53 ± 13.85 years for those with LPT. Regarding the modification of kidney replacement therapy, 5 patients (15.2%) in the LAPT group required a change, with four (80%) transitioning to hemodialysis and one (20%) adopting continuous ambulatory PD (CAPD); conversely, no patients in the LPT group required switch to another KRT.
Similar volumes of dialysis fluid were observed in both groups and at the beginning of the follow-up period, more patients in the LAPT group employed a long day dwell compared to the LPT group (P value 0.02)
APD emerges as a viable modality for patients with low and low average peritoneal transport. Nevertheless, it requires meticulous follow-up and a thorough assessment, including medical, nutritional, and nursing considerations. Further clinical trials or studies comparing patients with high and low peritoneal transport are crucial for improving patient outcomes and refining the overall effectiveness of PD as a therapeutic modality for CKD.