Relationship between intraperitoneal volume and intraperitoneal pressure during peritoneal dialysis-a pilot study in adult patients

腹膜透析过程中腹腔内容量与腹腔内压力的关系——一项成人患者的初步研究

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Abstract

Monitoring intraperitoneal pressure (IPP) offers valuable insights into changes of intraperitoneal volume (IPV) during peritoneal dialysis (PD). This study aims to investigate the relationship between IPV and IPP during a PD dwell. Thirteen patients were studied during a 2-h dwell using 2 L of dialysate containing 2.5% dextrose. IPP was measured using a pressure sensor integrated into an automated PD cycler. IPV was monitored concurrently by segmental bioimpedance (Hydra 4200). The density (ρ) of the PD dialysate was measured using a meter, and the creatinine and glucose concentrations in both dialysate (D) and serum (P) were measured pre- and post-PD dwell. A physical model (IPP = ρ × g × h), was used to describe the relationship between IPP and IPV, where h is the apparent dialysate height and g is the gravitational acceleration. The change in IPP (ΔIPP, -21.2 ± 18%) was mainly determined by the change of h (Δh, -20.9 ± 18.5%), while the change ρ (Δρ, -0.34 ± 0.06%), was minor. The study demonstrated an association between ΔIPP and the ratio of D/P creatinine and D/D(0) glucose, suggesting that ΔIPP may reflect membrane transport characteristics. Due to its noninvasive and seamless nature, the clinical utility of PD cycler-based measurement of IPP warrants further exploration.

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