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Understand the difference between clinical measured ultrafiltrationand real ultrafiltration in peritoneal dialysis.

Yu, Zanzhe; Wang, Zhuqing; Wang, Qin; Zhang, Minfang; Jin, Haijiao; Ding, Li; Yan, Hao; Huang, Jiaying; Jin, Yan; Davies, Simon; Fang, Wei; Ni, Zhaohui

Understand the difference between clinical measured ultrafiltrationand real ultrafiltration in peritoneal dialysis. Thumbnail


Authors

Zanzhe Yu

Zhuqing Wang

Qin Wang

Minfang Zhang

Haijiao Jin

Li Ding

Hao Yan

Jiaying Huang

Yan Jin

Wei Fang

Zhaohui Ni



Abstract

BACKGROUND: It has been noticed for years that ultrafiltration (UF) is important for survival in peritoneal dialysis. On the other hand, precise and convenient UF measurement suitable for patient daily practice is not as straight forward as it is to measure UF in the lab. Both overfill and flush before fill used to be source of measurement error for clinical practice. However, controversy finding around UF in peritoneal dialysis still exists in some situation. The current study was to understand the difference between clinical measured UF and real UF. The effect of evaporation and specific gravity in clinical UF measurement were tested in the study. METHODS: Four different brands of dialysate were purchased from the market. The freshest dialysate available in the market were intentionally picked. The bags were all 2?L, 2.5% dextrose and traditional lactate buffered PD solution. They were stored in four different conditions with controlled temperature and humidity. The bags were weighted at baseline, 6?months and 12?months of storage. Specific gravity was measured in mixed 24?h drainage dialysate from 261 CAPD patients when they come for their routine solute clearance test. RESULTS: There was significant difference in dialysate bag weight at baseline between brands. The weight declined significantly after 12?month's storage. The weight loss was greater in higher temperature and lower humidity. The dialysate in non-PVC package lose less weight than PVC package. The specific gravity of dialysate drainage was significantly higher than pure water and it was related to dialysate protein concentration. CONCLUSION: Storage condition and duration, as well as the type of dialysate package have significant impact in dialysate bag weight before use. Evaporation is likely to be the reason behind. The fact that specific gravity of dialysate drainage is higher than 1?g/ml overestimates UF in manual exchanges, which contributes to systemic measurement error of ultrafiltration in CAPD. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT03864120 (March 8, 2019) (Understand the Difference Between Clinical Measured Ultrafiltration and Real Ultrafiltration).

Journal Article Type Article
Acceptance Date Oct 26, 2021
Publication Date Nov 15, 2021
Publicly Available Date Mar 28, 2024
Journal BMC Nephrology
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 22
Article Number 382
DOI https://doi.org/10.1186/s12882-021-02589-3
Publisher URL https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-021-02589-3

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