#3478 THE EFFECT ON NET ULTRAFILTRATION WHEN TRANSFERRING PATIENTS FROM NOCTURNAL INTERMITTENT (NIPD) TO CONTINUOUS CYCLING PERITONEAL DIALYSIS (CCPD)

Abstract

Abstract Background and Aims Peritoneal Dialysis (P.D.) Adequacy includes a variety of targets such as the sufficient uremic toxins removal (Κt/V), patients’ euvolemia, acid-base and electrolyte balance etc.. Based on incremental PD prescription NIPD is often a reasonable modality choice when there is adequate Residual Renal Function (RRF). Eventually due to RRF decrease patients need to increase their PD adequacy by adding a solution during the day i.e Icodextrin (CCPD). The aim of this study was to evaluate the alteration of Cyclers’ ultrafiltration(UF) as well as Total Ultrafiltration (sum of Cycler ultrafiltration and the UF of the initial drainage) when transferring patients from NIPD to CCPD Method This is a single center retroprospective study of 16 patients (m = 9,f = 7). These patients were transferred from NIPD to CCPD due to inadequate PD adequacy. The patients’ mean age was 53.4±19 years, their mean PD duration was 74.3±25.7 months and their mean Peritoneal Solute Transfer Rate (PSTR-D/Pcr) was 0.69±0.12. We evaluated small solute clearance targets (Kt/V – t:total,p:peritoneal,r:renal), RRF (eGFR, Vurine), Cycler’ ultrafiltration, the UF of the initial drainage and the sum of them (Total UF) on three consecutive days before the initiation of CCPD and three consecutive days after the initiation. The patients’ cycler treatment program remain constant and all of them received an initial day volume of 1000 ml with Icodextrin. Results We compared the alterations with Paired t-Test (normal distripution) We found a statistically significant improvement of the peritoneal fraction of Kt/V when applying CCPD (p = 0.01), on the other hand we found a statistically significant decrease from Cycler's UF (p<0.05) as well as from Total UF (p<0.05) without any statistically significant increase in urine's volume. Additionally, from the regression analysis there was statistically significant correlation between PSTR and ΔUF(UFNIPD-UFCCPDtotal) showing that the faster the transporter the greater the ultrafiltration loss (p = 0.035, R = 0.58). Conclusion Transferring patients with adequacy problems from NIPD to CCPD improves small solute clearances but in some cases the risk for total ultrafiltration decrease is important and may lead to overhydration. It is necessary to contact perspective studies with hydration status evaluation ie Bioimpedance Spectroscopy.