13 BPU368972.indd

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Background: Ultrafiltration failure is a significant cause of technique failure for peritoneal dialysis and subsequent transfer to hemodialysis. Summary: Ultrafiltration failure is defined as failure to achieve at least 400 ml of net ultrafiltration during a 4 h dwell using 4.25% dextrose. Four major causes of ultrafiltration failure have been described. A highly effective peritoneal surface area is characterized by transition to a very rapid transport state with D/P creatinine >0.81. Low osmotic conductance to glucose is characterized by attenuation of sodium sieving and decreased peritoneal free water clearance to <26% of total ultrafiltration in the first hour of a dwell. Low effective peritoneal surface area manifests with decreases in the transport of both solute and water. A high total peritoneal fluid loss rate is the most difficult to diagnose clinically; failure to achieve ultrafiltration with an 8–10 h icodextrin dwell may provide a clue to diagnosis. Published online: January 20, 2015 Isaac Teitelbaum, MD, FACP, Professor of Medicine Director, Acute and Home Dialysis Programs University of Colorado Hospital, AIP 12605 E. 16th Avenue, Box F774, Aurora, CO 80045 (USA) E-Mail isaac.teitelbaum @ ucdenver.edu © 2015 S. Karger AG, Basel 0253–5068/15/0393–0070$39.50/0

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13 BPU368972.indd

Background: Ultrafiltration failure is a significant cause of technique failure for peritoneal dialysis and subsequent transfer to hemodialysis. Summary: Ultrafiltration failure is defined as failure to achieve at least 400 ml of net ultrafiltration during a 4 h dwell using 4.25% dextrose. Four major causes of ultrafiltration failure have been described. A highly effective peritoneal surface ar...

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13 BPU368972.indd

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تاریخ انتشار 2015