Utilize este identificador para referenciar este registo: http://hdl.handle.net/10400.16/1319
Título: Peritoneal membrane phosphate transport status: a cornerstone in phosphate handling in peritoneal dialysis
Autor: Bernardo, A.
Contesse, S.
Bajo, M.
Rodrigues, A.
Del Peso, G.
Ossorio, M.
Cabrita, A.
Selgas, R.
Data: Mar-2011
Editora: American Society of Nephrology
Citação: Clin J Am Soc Nephrol 6: 591–597, 2011
Resumo: BACKGROUND AND OBJECTIVES: Phosphate control impacts dialysis outcomes. Our aim was to define peritoneal phosphate transport in peritoneal dialysis (PD) and to explore its association with hyperphosphatemia, phosphate clearance (PPhCl), and PD modality. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Two hundred sixty-four patients (61% on continuous ambulatory PD [CAPD]) were evaluated at month 12. PPhCl was calculated from 24-hour peritoneal effluent. Phosphate (Ph) and creatinine (Cr) dialysate/plasma (D/P) were calculated at a 4-hour 3.86% peritoneal equilibration test. RESULTS: D/PPh correlated with D/PCr. PPhCl correlated better with D/PPh than with D/PCr. Prevalence of hyperphosphatemia (>5.5 mg/dl) was 30%. In a multiple regression analysis, only residual renal function was independently, negatively associated with hyperphosphatemia; in anuric patients, only D/PPh was an independent factor predicting hyperphosphatemia. D/PPh was 0.57 ± 0.10, and according to this, 16% of the patients were fast, 31% were fast-average, 35% were slow-average, and 17% were slow transporters. PPhCl was 37.5 ± 11.7 L/wk; it was lower in the slow transporter group (31 ± 14 L/wk). Among fast and fast-average transporters, PPhCl was comparable in both PD modalities. In comparison to automated PD, CAPD was associated with increased PPhCl among slow-average (36 ± 8 versus 32 ± 7 L/wk) and slow transporters (34 ± 15 versus 24 ± 9 L/wk). CONCLUSIONS: In hyperphosphatemic, particularly anuric, patients, optimal PD modality should consider peritoneal phosphate transport characteristics. Increasing dwell times and transfer to CAPD are effective strategies to improve phosphate handling in patients with inadequate phosphate control on automated PD.
Peer review: yes
URI: http://hdl.handle.net/10400.16/1319
ISSN: 1555/9041
Versão do Editor: http://cjasn.asnjournals.org/content/6/3/591.long
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