P1183EFFECT OF DECREASE IN GLUCOSE GRADIENT ON CHANGE IN INTRAPERITONEAL VOLUME USING SEGMENTAL BIOIMPEDANCE DURING PET

Abstract

Abstract Background and Aims The aim of this study was to investigate relationship of glucose gradient dynamics with change in intraperitoneal volume (IPV) measured by segmental bioimpedance analysis (SBIA). Method Ten PD patients (age 59±8.8 years, 7 females, 5 Blacks, weight 69.8±12.4 kg) were studied during standard peritoneal equilibrium test (PET). Dialysate glucose concentration (D) was measured hourly throughout the PET. IPV was monitoring continuously using SBIA (Hydra 4200; Zhu et al, Kidney Blood Press Res 2019). Hourly IPV was used to calculate (1) the difference between two conservative hours (ΔIPVt = IPVt+1 - IPVt; t=0, 1, 2 and 3) and (2) the IPVt / IPV0 ratio vs. the concurrent Dt/D0. Results IPVs were successfully measured in nine patients (1 high transporter, 6 high-average, 2 low-average). Ultrafiltration volume (UFV, 0.55±0.17 L) at the end of dwell was measured by SBIA. ΔIPV1(0.26±0.17 L) was positive during the first hour of dialysate dwell in 7 patients, their corresponding ΔD1 (calculated as D1 – D0) was -902±278 mg/dL. However, 2 patients (1 high and 1 high-average transporter) showed negative ΔIPV1(-0.13±0.1 L) and a ΔD1 of -861±367 mg/dL. The relationship between IPVt/ IPV0 and Dt/D0 is shown in Fig.1 (a) – (i). The figures indicate the dynamics of IPV and glucose concentration changes in all 9 patients. Conclusion Peak IPV appears at different time points and is associated with different glucose gradients. These findings may represent specific, individual characteristics of the peritoneal membrane. Since first hour ΔIPV represents almost half of total UFV at the end of dwell, it could emerge as an important indicator of peritoneal membrane characteristics. Monitoring IPV using SBIA provides a useful tool for further investigation.