Measurement of Peritoneal Fluid Handling in Children on Continuous Ambulatory Peritoneal Dialysis Using Autologous Hemoglobin

Author:

Reddingius Roel E.1,Schröder Cornelis H.1,Willems Hans L.2,Van Den Brandt Frans C.A.1,Koomen Gerardus C.M.3,Krediet Raymond T.3,Monnens Leo A.H.1

Affiliation:

1. Department of Paediatrics, Sint Radboud University Hospital, Nijmegen, Renal Unit

2. Department of Clinical Chemistry, Sint Radboud University Hospital, Nijmegen, Renal Unit

3. Department of Medicine, Academic Medical Centre, University of Amsterdam, The Netherlands

Abstract

Objective Previous measurements of peritoneal fluid handling in children treated by continuous ambulatory peritoneal dialysis (CAPD) were performed with human albumin as a fluid marker. A major disadvantage of this substance is that endogenous patient albumin enters the peritoneal cavity during the dwell period. For this reason perito neal fluid kinetics were measured in a group of children on CAPD, using autologous hemoglobin as a volume marker. Design Autologous hemoglobin was added to dialysate containing 1.36% glucose as a volume marker. Marker clearance (MC), which is presently the best available approximation of lymphatic absorption in the clinical setting, and transcapillary ultrafiltration (TCUF) were measured during a 4-hour dwell. Setting University hospital. Patients Children on CAPD (N=9), with a median age of 8.1 years (range 2.1–13.2 years). Results MC was 521±166 mL/4 hour/1.73 m2, which is high compared to the literature data on adult CAPD patients. TCUF was 519±92 mL/4 hour/1.73 m2, which is similar to data concerning adult patients. TCUF reached no maximum during the 4-hour dwell, and the deviation of the TCUF curve from linear was markedly less than usually seen in adult patients. Conclusions MC in children treated with CAPD is higher when compared to the literature data on adults. Difficulties to achieve sufficient ultrafiltration in children could be caused by relatively small differences between MC and TCUF from the beginning to the end of the dwell.

Publisher

SAGE Publications

Subject

Nephrology,General Medicine

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1. State-of-the-art drug delivery system to target the lymphatics;Journal of Drug Targeting;2024-02-05

2. Hyperpressure Intraperitoneal Fluid Administration for Control of Bleeding after Liver Injury;Journal of Surgical Research;2012-08

3. Evaluation of Intraperitoneal Pressure and the Effect of Different Osmotic Agents on Intraperitoneal Pressure in Children;Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis;2005-07

4. Peritoneal lymphatics;Textbook of Peritoneal Dialysis;2000

5. The Biology of the Mesothelium during Peritoneal Dialysis;Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis;1995-10

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