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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2021.tde-09092021-142126
Document
Author
Full name
Lucas de Jesus Pereira
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2020
Supervisor
Committee
Abensur, Hugo (President)
Alexandre, Cristianne da Silva
Elias, Rosilene Motta
Figueiredo, Ana Elizabeth Prado Lima
Title in Portuguese
Uso da solução de icodextrina para avaliar a capacidade de transporte peritoneal
Keywords in Portuguese
Diálise
Diálise peritoneal
Icodextrina
Peritônio
Teste de equilíbrio peritoneal
Ultrafiltração
Abstract in Portuguese
INTRODUÇÃO: O Teste de Equilíbrio Peritoneal (PET) é o padrão ouro para avaliar o transporte peritoneal. A aferição do volume drenado após 4 horas de permanência de uma solução de glicose a 4,25% permite avaliar, de maneira simplificada, a integridade da membrana peritoneal. OBJETIVO: desenvolver um método para avaliar o padrão de transporte peritoneal apenas com a aferição do volume drenado após 4 horas de permanência de uma solução de icodextrina a 7,5%. MÉTODOS: 35 pacientes em programa de diálise peritoneal foram submetidos a 03 procedimentos: PET, verificação do volume drenado após 4 horas de permanência com a solução de glicose a 4,25% e verificação do volume drenado após 4 horas de permanência com a solução de ICO. RESULTADOS: Os pacientes transportadores rápidos tiveram maior volume ultrafiltrado com o emprego da icodextrina. Houve correlação negativa entre o volume ultrafiltrado com icodextrina e a relação D4/D0 de glicose (R= -0.579 e p=0.002) e correlação positiva entre o volume ultrafiltrado com icodextrina e a relação D/Pcr (R=0.474 e p=0.002). A área abaixo da Curva ROC foi 0.867 (p<0.001) e 0.792 (p=0.004) respectivamente com PET de creatinina e glicose. Com a solução de glicose a 4,25% ela foi menor 0.738 e 0.710 (p=0.020 e p=0.041, respectivamente). O cut off de 141ml discriminou os pacientes médio-rápidos e rápidos transportadores dos pacientes médio-lentos e lentos transportadores. CONCLUSÃO: O volume drenado após 4 horas de permanência com ICO prevê melhor os padrões de transportes peritoneais em comparação com o volume drenado com solução contendo glicose a 4,25%
Title in English
Use of icodextrin solution to evaluate peritoneal transport capacity
Keywords in English
Dialysis
Icodextrin
Peritoneal dialysis
Peritoneal equilibration test
Peritoneum
Ultrafiltration
Abstract in English
BACKGROUND: The peritoneal equilibration test (PET) is the gold standard for evaluating peritoneal transport, and measurement of the drain volume after a 4-h dwell time with glucose 4.25% is a simple means of evaluating peritoneal membrane integrity. OBJECTIVE: to develop a method to evaluate the pattern of peritoneal transport only by measuring the drain volume after a 4-h dwell time with icodextrin 7.5%. METHODS: Patients in a peritoneal dialysis program (N = 35) underwent three procedures: a PET; determination of the drain volume after a 4-h dwell time with glucose 4.25%; and determination of the drain volume after a 4-h dwell time with icodextrin. RESULTS: Among the patients who were classified as high transporters, the ultrafiltration volume was greater after icodextrin use. The icodextrin ultrafiltration volume correlated negatively with the ratio between the 4-h and 0-h dialysate glucose concentrations (D4/D0 ratio, r = -0.579; p = 0.002), correlating positively with the dialysate-to-plasma ratio for creatinine (D/PCr ratio, r = 0.474; p = 0.002). For icodextrin, the area under the receiver operating characteristic curve was 0.867 and 0.792 for the D/PCr and D4/D0 ratios (p < 0.0001 and p = 0.004, respectively), compared with 0.738 and 0.710 for glucose 4.25% (p = 0.020 and p = 0.041, respectively). A cut-off volume of 141 mL discriminated high/high-average transporters from low/low-average transporters. CONCLUSIONS: The volume drained after icodextrin use better predicts peritoneal transport patterns than does that drained after the use of glucose 4.25%.
 
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Publishing Date
2021-09-09
 
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