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PubMed1996

Acid-base balance with different CAPD solutions.

Our objective is to investigate transperitoneal buffer fluxes with solution containing lactate and bicarbonate, and to compare the final effect on body base balance of the two solutions. One hundred and four exchanges, using different dwell times, were performed in 52 stable continuous ambulatory peritoneal dialysis (CAPD) patients. Dialysate effluent lactate and bicarbonate and volumes were measured. Net dialytic base gain was calculated. Patients' acid-base status and plasma lactate were determined. In lactate-buffer CAPD solution, lactate concentration in dialysate effluent inversely correlated with length of dwell time, but did not correlate with plasma lactate concentration and net ultrafiltration. Bicarbonate concentration in dialysate effluent correlated with plasma bicarbonate and dwell time but not with ultrafiltration. The arithmetic sum of the lactate gain and bicarbonate loss yielded the net dialytic base gain. Ultrafiltration was the most important factor affecting net dialytic base gain. A previous study demonstrated that in patients using a bicarbonate-buffered solution the net bicarbonate gain is a function of dwell time, ultrafiltration, and plasma bicarbonate. By combining the predicted data of the dialytic base gain with the calculated metabolic acid production, an approximate body base balance could be obtained with both lactate- and bicarbonate-buffered CAPD solutions. The body base balance in CAPD patients is self-regulated by the feedback between plasma bicarbonate concentration and dialytic base gain. The level of plasma bicarbonate is determined by the dialytic base gain and the metabolic acid production. This can explain the large interpatient variability in acid-base correction. Bicarbonate-buffered CAPD solution is equal to lactate solution in correcting acid-base disorders of CAPD patients.

Acid-Base Equilibrium↗

PubMed1989

Teicoplanin pharmacokinetics and bioavailability during peritoneal dialysis.

The pharmacokinetics of teicoplanin in serum and dialysate were examined in a crossover study after intravenous and intraperitoneal administration of a 3 mg/kg dose to five anuric patients who were undergoing continuous ambulatory peritoneal dialysis (CAPD). Blood and dialysate samples were obtained for 30 and 15 days, respectively, and were assayed microbiologically. The principal pharmacokinetic parameters after intravenous administration were as follows: total body clearance, 2.76 +/- 1.08 ml/min; elimination half-life, 377 +/- 109 hours; volume of distribution at steady state, 1.04 +/- 0.18 L/kg. Only 9% +/- 6% of the intravenous dose was recovered in the dialysate and the net peritoneal clearance was 0.25 +/- 0.21 ml/min. Bioavailability values, which were assessed by use of three methods after intraperitoneal administration and while dialysate was retained in the peritoneal cavity for 5 hours (dwell time), were 0.77 +/- 0.21, 0.78 +/- 0.05, and 0.76 +/- 0.08. Changes in bioavailability with dwell time were also examined. A dosing guide, which accounts for changes in bioavailability with dwell time, is presented.

Adult↗

PubMed1993

Measuring kinetics of complex single ion channel data using mean-variance histograms.

The measurement of single ion channel kinetics is difficult when those channels exhibit subconductance events. When the kinetics are fast, and when the current magnitudes are small, as is the case for Na+, Ca2+, and some K+ channels, these difficulties can lead to serious errors in the estimation of channel kinetics. I present here a method, based on the construction and analysis of mean-variance histograms, that can overcome these problems. A mean-variance histogram is constructed by calculating the mean current and the current variance within a brief "window" (a set of N consecutive data samples) superimposed on the digitized raw channel data. Systematic movement of this window over the data produces large numbers of mean-variance pairs which can be assembled into a two-dimensional histogram. Defined current levels (open, closed, or sublevel) appear in such plots as low variance regions. The total number of events in such low variance regions is estimated by curve fitting and plotted as a function of window width. This function decreases with the same time constants as the original dwell time probability distribution for each of the regions. The method can therefore be used: 1) to present a qualitative summary of the single channel data from which the signal-to-noise ratio, open channel noise, steadiness of the baseline, and number of conductance levels can be quickly determined; 2) to quantify the dwell time distribution in each of the levels exhibited. In this paper I present the analysis of a Na+ channel recording that had a number of complexities. The signal-to-noise ratio was only about 8 for the main open state, open channel noise, and fast flickers to other states were present, as were a substantial number of subconductance states. "Standard" half-amplitude threshold analysis of these data produce open and closed time histograms that were well fitted by the sum of two exponentials, but with apparently erroneous time constants, whereas the mean-variance histogram technique provided a more credible analysis of the open, closed, and subconductance times for the patch. I also show that the method produces accurate results on simulated data in a wide variety of conditions, whereas the half-amplitude method, when applied to complex simulated data shows the same errors as were apparent in the real data. The utility and the limitations of this new method are discussed.

Algorithms↗

PubMed1984

Gating kinetics of batrachotoxin-modified sodium channels in neuroblastoma cells determined from single-channel measurements.

We have observed the opening and closing of single batrachotoxin (BTX)-modified sodium channels in neuroblastoma cells using the patch-clamp method. The conductance of a single BTX-modified channel is approximately 10 pS. At a given membrane potential, the channels are open longer than are normal sodium channels. As is the case for normal sodium channels, the open dwell times become longer as the membrane is depolarized. For membrane potentials more negative than about -70 mV, histograms of both open-state dwell times and closed-state dwell times could be fit by single exponentials. For more depolarized potentials, although the open-state histograms could still be fit by single exponentials, the closed-state histograms required two exponentials. This data together with macroscopic voltage clamp data on the same system could be accounted for by a three-state closed-closed-open model with transition rates between these states that are exponential functions of membrane potential. One of the implications of this model, in agreement with experiment, is that there are always some closed BTX-modified sodium channels, regardless of membrane potential.

Animals↗

PubMed1995

The achievement of isoeffective bronchial mucosal dose during endobronchial brachytherapy.

PURPOSE: The use of endobronchial brachytherapy in the treatment of lung cancer is increasing due to the more widespread availability of high dose rate afterloading equipment. The complications include small airway (segmental and small lobar bronchi) fibrosis, stenosis, and obstructive complications in addition to hemorrhage. A progressive reduction in the diameter of the bronchial lumen occurs at each division of the bronchial tree. If uniform dwell times along a bronchial catheter treatment length are used, this will result in higher doses being given to the bronchial mucosa in the distal part of the treatment volume where the brachytherapy source mucosa distances are smaller, and underdosage proximally, where the source mucosa distances are larger. METHODS AND MATERIALS: The known mathematical relationships of the sequential reductions in the diameter of the bronchial lumen have been incorporated into two methods of optimization, which have been compared to uniform dwell times along a treatment length from trachea to segmental bronchus. RESULTS: The resulting isodose plots are presented, and demonstrate the extent of the overdosage distally, and the underdosage proximally when using uniform dwell times, and the achievement of isoeffective mucosal doses when using differential dwell times. CONCLUSION: This refinement in brachytherapy technique offers the potential for reduced normal tissue complications and possibly improved tumor control by reducing overdosage and underdosage, respectively.

Brachytherapy↗

PubMed2005

[Regulation of calcium-activated potassium channels of mesenteric artery smooth muscle from patients with essential hypertension by endothelin-1 and prostagl E1].

OBJECTIVE: To study regulation of Ca(2+)-activated K(+) channels (KCa) of mesenteric artery smooth muscle cell (SMC) from 21 old patients with essential hypertension (EH) by endothelin-1 (ET-1) and prostagl E(1) (PGE(1)). METHODS: Mesenteric artery branch from EH was digested by enzyme. Patch clamp technique was used to pull cell-attached and inside-out patches on mesenteric artery SMC from EH and the normotensive patients respectively. The signal channel open probability (Po), open dwell-time (To) and close dwell-time (Tc), open channel number per patch were recorded. After adding Ca(2+) (10(-8) approximately 10(-6) mol/L), ET-1(2 approximately 8 x 10(9) mol/L) and PGE(1) (10, 20, 40, 100, 200, 400 nmol/L) to cytoplasm respectively. The parameters above were observed again. RESULTS: Compared to that of normotensive patients, the activities of KCa channels of patients with EH was higher. After adding Ca(2+) to cytoplasm,the Po of KCa channels in normotensive patients increased significantly. But it was few changes in EH group. KCa channels has dual reaction to ET-1 in normotensive patients. We have found no statistics difference when ET-1 present on KCa channels of EH cases. Whereas PGE(1) can affect KCa channels current and channels kinetic significantly in side-out patches. The Po of KCa channels increased. The To protracted and the Tc curtailed in EH. CONCLUSIONS: The activities of KCa channels of patients with EH increased significantly. but the sensitive to Ca(2+) decreased. ET-1 were few effect to KCa channels. The PGE(1) can activated KCa channels of patients with EH.

Aged↗

PubMed1999

Volume-based dose optimization in brachytherapy.

PURPOSE: We address the question of how to optimize the dwell time distribution in brachytherapy with a stepping source if a minimal tumor dose is prescribed within the planning target volume (PTV). METHODS AND MATERIALS: For a given PTV, reference points inside and at the surface of the PTV are generated and dose constraints are prescribed. The dose at these reference points can be calculated if the positions of the sources are known. We determine a set of dwell times such that the dose constraints are fulfilled, and at the same time, the total irradiation time is minimized. The simplex algorithm allows us to find a solution (if any exists) for this problem. RESULTS: The performance of this method has been tested for a geometrically simple PTV. This method gives better results than conventionally used algorithms for dwell time optimization. CONCLUSION: The method described in this paper allows a volume-oriented optimization for brachytherapy dose distribution. The algorithm guarantees finding a dwell time distribution which fulfills the prescribed dose constraints, if any solution exists.

Algorithms↗

PubMed2000

Hurst analysis applied to the study of single calcium-activated potassium channel kinetics.

The gating of ion channels has been modeled by assuming that the transitions between open and closed states is a memoryless process. Nevertheless, analysis of records of unitary current events suggests that the kinetic process presents short-term memory, i.e. the open- and closed-dwell times are short-term correlated. Here the rescaled range analysis (R/S Hurst analysis) is used as a method to test long-term correlation, in single calcium-activated potassium channels present in Leydig cells. The Hurst coefficients, calculated for four different voltages (V) are: 0.634+/-0.022 (n=3) for V=+20 mV; 0.635+/-0.012 (n=4) for V=+40 mV; 0.606+/-0.020 (n=4) for V=+60 mV and 0.608+/-0.026 (n=4) for V=+80 mV. This indicates that open- and closed-dwell times are long-term correlated and do not change with the voltage applied to the patch at a 5% significance level (F=2.2402;p=0.140715). Randomly shuffling the experimental data removes the correlation in all voltages. When the Hurst method was applied to the results from a simulated three-state Markovian model, it could not account for the long-term correlation found in the experimental data. In this case, H has the following values: 0. 5498+/-0.018 (n=100) for V=+20 mV; 0.5557+/-0.0202 (n=100) for V=+40 mV; 0.5565+/-0.0246 (n=100) for V=60 mV and 0.5595+/-0.0247 (n=100) for V=+80 mV. Even a four-state Markovian model was not adequate to correctly simulate the long-term memory found experimentally, with H values significantly different from those found for the experimental data, in the same voltage range (F=15.0355;p=0.00001). In conclusion, this paper shows that: (1) the open- and closed-dwell times of the single calcium-activated potassium channel of Leydig cells are long-term correlated; (2) three- and four-state Markovian models, which describe very well the dwell time distributions, are not adequate to describe the long-term correlation found between the open and closed states of this ion channel.

Animals↗

PubMed1991

Accounting for the Ca(2+)-dependent kinetics of single large-conductance Ca(2+)-activated K+ channels in rat skeletal muscle.

1. The Ca(2+)-dependent kinetics of large-conductance Ca(2+)-activated K+ channels from cultured rat skeletal muscle were studied with the patch clamp technique. Data were collected in the absence of Na+ and Mg2+, which can alter the kinetics. About 2 x 10(5) open and shut intervals were analysed from each of five different excised membrane patches containing a single active channel. Analysis was restricted to activity in the normal mode, which includes 96% of the intervals. 2. The open probability (Popen) and dwell-time distributions of open and shut intervals were obtained at three to four different [Ca2+]i for each of the channels. Popen data were also obtained from some multichannel patches. 3. Increasing [Ca2+]i increased Popen. At a pH of 7.0 the Hill coefficient was 3.7 +/- 0.8 (range of 3.0-5.0) and a Popen of 0.5 occurred at 14 +/- 7 microM [Ca2+]i (K0.5) for data obtained at +30 mV (n = 6). At a pH of 7.2 the Hill coefficient was 3.0 +/- 0.5 (range of 2.2-3.7) and K0.5 was 9 +/- 6 microM-Ca2+ (n = 7). The large standard deviations for K0.5 reflect the observation that fourfold differences in K0.5 could be observed for different channels studied under the same experimental conditions. 4. Hill coefficients that can be greater than 3 suggest that the channel may bind four or more Ca2+ to become fully activated. The binding of four Ca2+ before opening would require a minimum of five shut states. This estimate of the minimum number of shut states is in general agreement with that obtained from the number of exponential components in the dwell-time distributions of shut intervals. Thus, two different methods give similar estimates of the minimum number of shut states. If the channel can open with different numbers of bound Ca2+, then this could give rise to the three to four open states suggested by the three to four exponential components in the open dwell-time distributions. 5. Kinetic schemes consistent with the Ca(2+)-dependent kinetics were developed by simultaneously fitting open and shut dwell-time distributions obtained at three to four different [Ca2+]i, using maximum likelihood techniques and corrections for missed events. Such simultaneous fitting can provide an increased ability to define models and rate constants.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

PubMed1994

Optimization of CCPD prescription in children using peritoneal equilibration test.

Continuous cycling peritoneal dialysis (CCPD) is automatically performed by a cycler as a repetition several times per session of the same programmed exchange. We have investigated the efficiency, in terms of ultrafiltration (UF) capacity and solute clearance (phosphate), of an adapted (optimized) CCPD versus a conventional CCPD. Adapted CCPD was performed manually in order to allow a combination of short dwell times (optimal ultrafiltration) and long dwell times (optimal purification). The ratio of ultrafiltration over glucose absorbed (UF/G) was higher with adapted CCPD (5.7 +/- 0.8) compared with conventional CCPD (4.8 +/- 1.3). Phosphate purification was also enhanced with adapted CCPD (0.21 +/- 0.05 versus 0.16 +/- 0.05 mL/min/kg). These results confirm the usefulness of the concept of adapted CCPD with variable dwell times for optimization of peritoneal dialysis performances in children.

Absorption↗

PubMed1998

Indentation creep behavior of a direct-filling silver alternative to amalgam.

Amalgam creep has been identified as a key parameter associated with marginal breakdown and corrosion. The aim of this study was to evaluate the time-dependent deformation (creep) of a novel silver filling material as an alternative to amalgam. We made the silver specimens by pressing a precipitated powder at room temperature to a density that can be achieved in clinical hand consolidation. The surface of the silver was either polished or burnished. To examine local contact creep and the effect of surface finishing, we used an indentation creep method in which a Vickers indenter was loaded on the specimen surface at a load of 10 N with dwell times of 5 sec to 6x10(4) sec. We used a bonded-interface technique to examine subsurface creep mechanisms. The flexural strength (mean+/-SD; n = 10) was 86+/-20 MPa for amalgam, 180+/-21 MPa for polished silver, and 209+/-19 MPa for burnished silver-values which are significantly different from each other (family confidence coefficient = 0.95; Tukey's multiple-comparison test). Indentation creep manifested as hardness number decreasing with increased dwell time. With dwell time increasing from 5 sec to 6x10(4) sec, the hardness number of amalgam was reduced by approximately 80%; that of the polished silver and the burnished silver was reduced by only 40%. Subsurface creep in amalgam consisted of the shape change of the alloy particles from spherical to elongated shapes, and the separation of matrix grains from each other, possibly due to grain-boundary sliding. Creep of the polished silver occurred by densification reducing porosity and increasing hardness; that of the burnished silver occurred by the displacement of the burnished layer. These results suggest that, due to creep-induced subsurface work-hardening and densification, the consolidated silver exhibits a higher resistance to indentation creep than does amalgam. The hardness number of silver approaches that of amalgam after prolonged indentation loading.

Analysis of Variance↗

PubMed2005

Optimizing the acquisition time profile for a planar integral measurement system with a spinning slat collimator.

This article considers a hypothetical imaging device with a spinning slat collimator that measures parallel-planar-integral data from an object. This device rotates around the object 180 degrees and stops at N positions uniformly distributed over this 180 degrees. At each stop, the device spins on its own axis 180 degrees and acquires measurements at M positions uniformly distributed over this 180 degrees. For a fixed total imaging time, an optimal distribution of the scanning time among the data measurement locations is searched by a nonlinear programming method: Nelder-Mead's simplex method. The optimal dwell time is approximately proportional to the weighting factor in the backprojector of the reconstruction algorithm. By using an optimal dwell-time profile, the reconstruction signal-to-noise ratio has a gain of 23%-24% for the filtered backprojection algorithm and a gain of 10%-18% for the iterative algorithms, compared with the situation when a constant dwell-time profile is used.

Algorithms↗

PubMed2000

Travel time and concurrent-schedule choice: retrospective versus prospective control.

Six pigeons were trained on concurrent variable-interval schedules in which two different travel times between alternatives, 4.5 and 0.5 s, were randomly arranged. In Part 1, the next travel time was signaled while the subjects were responding on each alternative. Generalized matching analyses of performance in the presence of the two travel-time signals showed significantly higher response and time sensitivity when the longer travel time was signaled compared to when the shorter time was signaled. When the data were analyzed as a function of the previous travel time, there were no differences in sensitivity. Dwell times on the alternatives were consistently longer in the presence of the stimulus that signaled the longer travel time than they were in the presence of the stimulus that signaled the shorter travel time. These results are in accord with a recent quantitative account of the effects of travel time. In Part 2, no signals indicating the next travel time were given. When these data were analyzed as a function of the previous travel time, time-allocation sensitivity after the 4.5-s travel time was significantly greater than that after the 0.5-s travel time, but no such difference was found for response allocation. Dwell times were also longer when the previous travel time had been longer.

Animals↗

PubMed2001

Markovian models of low and high activity levels of cardiac ryanodine receptors.

The modal gating behavior of single sheep cardiac sarcoplasmic reticulum (SR) Ca2+-release/ryanodine receptor (RyR) channels was assessed. We find that the gating of RyR channels spontaneously shifts between high (H) and low (L) levels of activity and inactive periods where no channel openings are detected (I). Moreover, we find that there is evidence for multiple gating modes within H activity, which we term H1 and H2 mode. Our results demonstrate that the underlying mechanisms regulating gating are similar in native and purified channels. Dwell-time distributions of L activity were best fitted by three open and five closed significant exponential components whereas dwell-time distributions of H1 activity were best fitted by two to three open and four closed significant exponential components. Increases in cytosolic [Ca2+] cause an increase in open probability (Po) within L activity and an increase in the probability of occurrence of H activity. Open lifetime distributions within L activity were Ca2+ independent whereas open lifetime distributions within H activity were Ca2+ dependent. This study is the first attempt to estimate RyR single-channel kinetic parameters from sequences of idealized dwell-times and to develop kinetic models of RyR gating using the criterion of maximum likelihood. We propose distinct kinetic schemes for L, H1, and H2 activity that describe the major features of sheep cardiac RyR channel gating at these levels of activity.

Animals↗

PubMed1994

The peritoneal equilibration test variables in pediatric CAPD patients.

The peritoneal equilibration test (PET) is generally accepted as a valuable tool in individualizing continuous ambulatory peritoneal dialysis (CAPD) treatment schedules in adults. However, the classification of peritoneal permeability as described by Twardowski is not available for children due to differences in peritoneal transport abilities. In this paper, we report the results of the PET for 20 patients aged from 1.5 to 24 years (mean 10.3 years), who started CAPD therapy at age 0-15 years, using Twardowski's standardized technique. D/P creatinine (dialysate to plasma ratio of creatinine at 4 h), D/D0 glucose (the ratio of dialysate glucose at 4 h dwell time to dialysate glucose at 0 dwell time), and the residual volume (RV) in the abdominal cavity were calculated. The mean and standard deviation values for D/P creatinine and D/D0 glucose were of a higher permeability level than those reported in Twardowski's data. Furthermore, a significant correlation of creatinine and glucose with fluid drainage ability of the peritoneum were observed. A large amount of RV (425 +/- 125 mL/m2) was detected in the patients' peritoneal cavity and this had a significant correlation with dialysate leak occurrences. The authors suggest that the RV would be an indicator for leaks and especially latent leaks. The cause of a large RV is unknown, but there is a probability that drainage volume and transport rates of metabolites decrease because the concentration of the instilled dialysate is immediately diluted by a large RV within the peritoneum.

Adolescent↗

PubMedDate not supplied

Changes in peritoneal equilibration test values during long-term peritoneal dialysis in peritonitis-free children.

Little is known about the changes in peritoneal equilibration test (PET) values in children on long-term peritoneal dialysis (PD). In the present study, a PET was carried out every 6 months in 39 children (mean age 8.8 +/- 5.5 years) undergoing PD for 6 to 85 months (mean 36.9 +/- 23.1 months). Patients experiencing peritonitis were excluded. Both D/P creatinine (dialysate-to-plasma ratio of creatinine at 4 hours) and D/D0 glucose (ratio of dialysate glucose at 4 hours' dwell time to dialysis glucose at 0 dwell time) were measured 195 times in this series of patients. No remarkable change was found for D/P creatinine or D/D0 glucose during the first 24 months of PD but thereafter, D/P creatinine increased gradually and D/D0 glucose decreased gradually. Mean D/P creatinine increased significantly after the first 24 months of PD: from 0.66 +/- 0.12 during the first 24 months, to 0.70 +/- 0.09 after 25 months and more of PD (p = 0.0051). Mean D/D0 glucose decreased significantly after 24 months of PD: from 0.42 +/- 0.09 during the first 24 months, to 0.38 +/- 0.08 after 25 months and more of PD (p = 0.0015). The most significant change for both D/P creatinine and D/D0 glucose occurred after 24 months of PD. It seems reasonable to consider the mean PET values at 24 months of PD as the standard PET values.

Adolescent↗

PubMedDate not supplied

Results of peritoneal equilibration test during treatment with polyglucose dialysis solution.

BACKGROUND: Results of peritoneal equilibration test (PET) suggest prolonged effect of polyglucose dialysis solution (PG-DS) on peritoneal permeability. OBJECTIVES: An evaluation of dialysate-to-plasma ratio (D/P) of urea, DIP creatinine, and D/D0 glucose (ratio of dialysate glucose at designated dwell time to dialysate glucose at 0 dwell time), and mass transfer area coefficients (KBD) of these solutes in PET before introduction, during administration, and after discontinuation of PG-DS hi patients treated with continuous ambulatory peritoneal dialysis (CAPD). DESIGN: Single-center prospective study with PG-DS; retrospective selection of the control group. SETTING: Peritoneal dialysis unit in a university hospital. PATIENTS: Fourteen patients (11 males; age 45.1 +/- 8.5 years) treated with CAPD for 17.5 +/- 9.9 months. 7.5% PG-DS was used for the overnight exchange. After discontinuation of the PG-DS, standard dialysis solutions, as previously used, were reintroduced. The control group was selected to match both CAPO duration and peritoneal permeability of the patients in the PG-DS group at the start of the study. METHODS: Standard PET was carried out at 1.6 +/- 0.8 months before the introduction of PG-DS (study period I, n = 14), after 1.2 +/- 0.6 months' use of PG-DS (study period II, n = 14), after 4.4 +/- 0.8 months' use of PG-DS (study period Ill, n = 11), after 8.8 +/- 2.2 months' use of PG-DS (study period IV, n = 9), and at 2.0 +/- 0.6 months after PG-DS discontinuation (study period V, n = 11). Patients in the control group underwent PET at similar time intervals (control periods I-V). RESULTS: In the PG-DS group, a tendency toward increased peritoneal permeability for urea and creatinine was shown during the consecutive study periods. D/D0 glucose was significantly higher only in the PET performed during use of PG-DS (periods II-IV) compared to results obtained in period I. In the control group, both D/P and KBD of both urea and creatinine remained unchanged, but K90 glucose was higher in the first 2 hours of the PET in control period V compared to respective values in control period III. CONCLUSION: Changes in peritoneal permeability are observed In CAPD patients treated with PG-DS. These changes may be at least partially related to the administration of polyglucose.

Adult↗

PubMed2002

Differences in peritoneal equilibration test results in patients aged above or below 60 years.

Peritoneal permeability, evaluated using the peritoneal equilibration test (PET), indicates that, in an adult population not selected for age, an increase in the transport rate of small solutes usually occurs in the course of peritoneal dialysis (PD) treatment. We evaluated the dialysate-to-plasma ratio of urea (D/P urea), the D/P creatinine, the ratio of dialysate glucose at a designated dwell time to dialysate glucose at 0 dwell time (D/D0 glucose), and the mass transfer-area coefficients (KBDs) of those solutes in PETs performed in patients aged above or below 60 years who were matched for sex, PD duration, and outcome. The single-center, retrospective study was carried out in a peritoneal dialysis unit in a university hospital. Two groups of PD patients were chosen. Mean age of patients in group I (n = 21; 9 women, 12 men) was 67.7 +/- 4.5 years; PD duration was 20.1 +/- 12.1 months. In group II, the patients (n = 21; 9 women, 12 men) had a mean age of 42.8 +/- 9.1 years, and had been treated with PD for 20.7 +/- 12.1 months. A standard PET was performed according to Twardowski et al every 3 months from PD start to PD end. The first results, the mean results representing the entire PD course, and the last results were compared between groups. In addition, the first and the last results were compared within each group. No significant differences were seen between the groups in peritoneal transport in the first PET. In the last PET, the curves for D/P urea and D/P creatinine, and the KBD for urea, were significantly lower in the older patients than the curves obtained at PD start. In consequence, a tendency toward lower D/P ratios or KBDs for urea and creatinine in the last and mean PETs was observed in group I as compared with group II. No significant changes were seen in the peritoneal transfer of glucose in the course of PD or between groups. Older patients may show a reduction in peritoneal permeability from the vascular to the mesothelial side of the membrane in the course of PD treatment; peritoneal transport in the opposite direction remains unchanged during approximately 20 months from the start of PD treatment. The patients under 60 years of age maintain stable bi-directional permeability under a comparable PD duration.

Adult↗