Document Detail


Peritoneal dialysis prescription: the "Clearance Peak" model.
MedLine Citation:
PMID:  7896427     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Creatinine clearance (CRCL) was studied in 20 patients on CAPD in relation to the dwell times (DT), in order to establish a personalised dialysis schedule with the best clearance (CL) results, while respecting the patient's life-style. By calculating the CRCL from the two exchanges with dwell-times of 4 and 8 hours (2 I, 2.27%), curves (2nd degree polynomial regression) were plotted with three points (0h, 4h, 8h) for CRCL and the ultrafiltration rate (UF) as a function of the DT. The DT corresponding to the CRCL peak (CLPeak-time) was calculated for each subject with the first derivative of the function. On the basis of the CRCL obtained with the three most common DT (4h, 6h, 8h), we divided the patients into three categories (CLPeak-time < 5h: "fast", 5-7h: "normal"; > 7h: "slow") for the best CRCL correspondence of the 4h, 6h or 8h exchanges respectively. Also the 8h/4h ratio was used to determine CLPeak-time. For each of the three categories there is a corresponding dialysis schedule for the best CRCL and UF results of the exchanges with DT of 4, 6 and 8 hours, plus the theoretical calculation of the daily CRCL obtainable ("fast": APD; "normal": CAPD 4 exchanges/DAPD 4 exchanges; "slow": CAPD 4 exchanges). The "CLPeak" dialysis prescription model therefore identifies the most advantageous DT for each patient by using the CRCL values of two 2.27% exchanges of 4 and 8h respectively. Functional classification into three categories may give a rational orientation to dialysis prescription in order to reach the maximum CRCL possible with the individual peritoneal transport rates.
Authors:
G Virga; G Amici; G Da Rin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The International journal of artificial organs     Volume:  17     ISSN:  0391-3988     ISO Abbreviation:  Int J Artif Organs     Publication Date:  1994 Oct 
Date Detail:
Created Date:  1995-04-27     Completed Date:  1995-04-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7802649     Medline TA:  Int J Artif Organs     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  537-42     Citation Subset:  IM    
Affiliation:
Nephrology and Dialysis Division, Regional Hospital S. Maria dei Battuti, Treviso, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Computer Simulation
Creatinine / metabolism*
Female
Humans
Life Style
Male
Middle Aged
Models, Biological
Peritoneal Dialysis, Continuous Ambulatory*
Ultrafiltration
Uremia / metabolism,  therapy*
Chemical
Reg. No./Substance:
60-27-5/Creatinine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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