Acceptability of 2-Liter Volume in Filipino Continuous Ambulatory Peritoneal Dialysis Patients

Abstract

To determine whether there is any significant difference in symptoms resulting from the use of the 1.5 L versus the 2.0 L continuous ambulatory peritoneal dialysis (CAPD) bag in patients on regular CAPD. Patients were randomized to receive either 1.5 L or 2.0 L fill volumes using a 1.5% dextrose solution, with the dialysate allowed to dwell for 2 hours. Patients were then asked to answer a questionnaire to determine if they experienced any discomfort during the dwell period. Symptoms were also analyzed using a score of one point for every type of discomfort experienced by the patient and 0 if the symptom was absent. The number of patients in each group who had no discomfort symptoms, discomfort symptom scores between 0 and 5, or more than five discomfort symptoms was determined. Sixty patients were enrolled in the study, with 30 patients in each treatment group. The study groups were comparable in age, sex, primary renal disease, body surface area, height, and weight. They differed in duration on CAPD before administration of the test. Patients in the 1.5 L group were on CAPD for a shorter period (median, 5 days) than those in the 2.0 L group (median, 92 days; p = 0.00, Mann-Whitney test). Fourteen patients (46.7%) in the 1.5 L group and 11 patients (36.7%) in the 2.0 L group experienced discomfort symptoms. Only three patients (10.0%) in each of the two study groups experienced abdominal pain. Patients were asked to answer a clinical assessment questionnaire on what type of discomfort they experienced during dwell time. The proportions of patients with difficulty breathing, abdominal pain, and difficulty sitting were significantly higher among those in the 1.5 L group than the 2.0 L group. Logistic regression analysis to control for the effect of the time interval in order to determine whether there was any difference between the groups in the discomfort experienced showed that there was no significant difference. There was also no significant difference in symptom score between the two groups. There was no increase in abdominal discomfort when patients used the 2.0 L dialysis fluid bag compared to the 1.5 L bag. The hesitancy of patients to use larger volume exchange may be due to patient bias rather than abdominal discomfort. [ Hong Kong J Nephrol 2003;5(2):84-9]