Endocrine Abstracts

The efficacy of peritoneal dialysis (PD) is closely related to the status of the peritoneum. Long-term PD leads to structural and functional changes in the peritoneum and affects dialysis adequacy. Also high-glucose content of dialysate accelerates peritoneal fibrosis. It is reported that ultrasonography (USG) reflects parietal peritoneal membrane thickness and PD duration is related with peritoneal thickness. This study aimed to evaluate peritoneal thickness with USG in PD patients.

Method: A total 20 adult PD patients (mean age 48.8±3.8 years, 65% female) were included in the study. The patients used continuous ambulatory (n=14) or automated (n=6) PD regimen with 1.36%, 2.27% and 3.86% glucose based solutions. Patients were divided into two groups according to PD treatment durations: shorter than 60 months (Group 1, 34.6±4.8 months, n=10) and longer than 60 months (Group 2, 110.9±8.6 months, n=10). Dialysis adequacy (D/P creatinine, pKT/V, creatinine clearance) and parietal peritoneum thickness of two groups were measured.

Results: The mean ages, gender distributions, body mass indexes and PD types of both groups were comparable. There was no statistically significant difference between D/P creatinine, pKT/V and creatinine clearance values of the two groups at the initial and last visits. The final ultrafiltration amount was significantly higher (1269±496 vs. 847±344 mL, P=0.034) and the residual urine volume was significantly lower (275±544 vs. 799±525 mL, P=0.016) in group 2. In all patients, the creatinine clearance and the amount of residual urine significantly decreased, and the amount of ultrafiltration increased over time (P<0.001). There was no significant difference in creatinine clearance, ultrafiltration amount and residual urine volume percent changes between the two groups. Parietal peritoneum thickness values of group 1 and 2 were similar in the right upper (0.38±0.11 vs. 0.40±0.06 mm), left upper (0.40±0.07 vs. 0.41±0.11 mm), right lower (0.42±0.11 vs. 0.41±0.11 mm) and left lower (0.42±0.11 vs. 0.41±0.09 mm) zones, respectively (P>0.05).

Conclusion: As the duration of PD treatment increases, the peritoneal structure changes. We did not find out any difference in peritoneal thickness between the groups according to PD duration. We found a decrease in PD efficacy over time with glucose based solutions in different concentrations, but this decrease was not related to the duration of the treatment.