![]() ![]() Some labs may not report the D/P urea ratios or urea transport classification, but the urea data may be required for prescription modeling. ![]() For example, if the 4-hour D/P creatinine is 0.59 and the 4-hour D/D0 glucose is 0.47, the patient would be classified as low average. Generally, patients are categorized based on the 4-hour D/P creatinine and D/D0 glucose ratios. The outer edges of the blue and green areas represent the maximum and minimums for the group. One standard deviation up or down-the dashed white lines-then sets the cutoffs between high and high-average transporters and low and low-average transporters. The solid white line is the average equilibration ratio for that population. ![]() Using data from the original 103 patients, Twardowski created these standardized equilibration curves that are still in use today. ![]() It is from these equilibration ratios that transport types are determined. For glucose, dividing the dialysate glucose concentration at each time point by the glucose concentration in the 0-hour dialysate sample results in the equilibration ratios. This means that the concentration of urea or creatinine in the dialysate at each time point is divided by the concentration of urea or creatinine in the plasma, or serum, sample. For urea and creatinine, this is calculated as the dialysate-to-plasma, or D-to-P, ratio. Once the PET samples are collected, both the serum and dialysate samples are analyzed for urea, creatinine and glucose to calculate equilibration ratios. All dialysate samples and the serum sample are then analyzed for urea, creatinine and glucose. Accurately measure the drain volume by weighing before collecting a 10-mL sample of dialysate for analysis. Again, to ensure as much effluent as possible is drained, you can have the patient lie down and roll from side to side at the end of the drain. At the 2-hour timepoint, repeat the collection steps (drain 200 mL, mix, aseptically obtain 10-mL sample, then reinfuse) and take a blood sample for serum measurements.Īfter 4 hours of dwell, completely drain the patient from an upright position for at least 20 minutes. For the remainder of the 4-hour dwell, the patient should be upright and ambulatory. The remaining dialysate is then reinfused back into the patient. Mix the drained dialysate by inverting the bag several times then obtain a 10-mL sample using aseptic technique. Once the infusion is complete, immediately drain 200 mL of dialysate. Every 2 minutes have the patient roll from side to side to mix the dialysate. To ensure as much effluent as possible is drained, the patient can lie down and roll from side to side at the end of the drain.įor the PET, 2L of 2.5% dextrose dialysate is infused over 10 minutes. When the patient arrives at the clinic the morning of the PET, the overnight dwell is drained while the patient is sitting up for at least 20 minutes. The process starts with a long overnight dwell of 8–12 hours. We will focus here on the most commonly performed standard PET, originally described by Dr. Each test addresses different aspects of peritoneal function. There are numerous options for peritoneal membrane testing and no one test has been recommended over another. It can also monitor how peritoneal function varies over time. Peritoneal testing allows for assessment of a patient's membrane characteristics that in turn can be useful for development of patient-optimized PD treatment prescriptions. There is considerable inter- and intra-patient variability in solute transport and ultrafiltration capacity in peritoneal dialysis (PD). WHAT IS THE PERITONEAL EQUILIBRATION TEST (PET)? INTERPRETING THE PERITONEAL EQUILIBRATION TEST (PET) ![]()
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