Fast Peritoneal Equilibration Test

 

Patient Preparations:

(1) Patient should have adequate glucose control before testing is begun. Plasma glucose values > 300 mg/dL can result in improper patient classification.

(2) Patient should be as close to euvolemic as possible.

(3) Residual volume should be standardized. Poorly draining catheters can result in high residual volumes and unreliable results. For patients with a very low residual volume such as those on intermittent peritoneal dialysis, the abdomen may be prefilled with 2-liters of a 1.5% dextrose dialysis solution about 2 hours before the actual test; this is then drained as for the overnight dwell..

 

Procedure:

(1) The peritoneal cavity is drained after an overnight dwell over 20 minutes.

(2) 2 liters of a warmed 2.5% dextrose dialysis solution is infused over 10 minutes, with the patient rolled from side to side every 400 mL is infused.

(3) A blood sample is obtained during the dwell period.

(4) After a 4 hour dwell period, the dialysate is drained over 20 minutes.

 

Testing:

(1) blood sample: plasma creatinine

(2) dialysate: creatinine and glucose

 

dialysate-to-plasma creatinine ratio =

= (dialysate creatinine concentration in mg/dL) / (plasma creatinine concentration in mg/dL)

 

net ultrafiltration =

= (drainage volume in mL) - (volume infused in mL)

 

Interpretation:

• Reduced or absent ultrafiltration is termed ultrafiltration failure and occurs in some patients on long-term peritoneal dialysis. In these patients peritoneal dialysis results in underdialysis and is no longer useful.

Dialysate to Plasma Creatinine Ratio	Dialysate Glucose mg/dL	Ultrafiltration Volume in mL (with fill volume 2,050 mL)	Net Ultrafiltration in mL (with fill volume 2,050 mL)	Transport Classification
0.34 - 0.49	945 - 1214	2651 - 3326	600 - 1276	low
0.50 - 0.64	724 - 944	2369 - 2650	320 - 600	low-average
0.65	723	2368	320	mean
0.66 - 0.81	502 - 722	2085 - 2367	35 - 320	high-average
0.82 - 1.03	230 - 501	1580 - 2084	(-470) - 35	high