A commentator on this board and I have been comparing notes on our individual treatments. While this is instructive and interesting, you have to keep in mind that we are each individuals into ourselves and it’s easy to fall into the trap of comparing apples to oranges. The following table depicts differences and similarities in our PD:
| My Readings | His Readings | |
| UFiltration | 4-800 mL | 11-1300 mL |
| # Cycles | 4 | 5 |
| Dwell | 120 minutes | 90 minutes |
| Total Time | 10-5 to 11 (Hr-min) | 10-5 to 12-15 |
At first glance, it would appear that “him” is pulling lots more fluid out via PD compared to me as indicated by the comparison of the UFiltration (microfiltration) numbers. But this is misleading. What we don’t know and can’t compare is how much urine each of us is still making via normal kidney function. I still pass a plausible amount of urine naturally; does he? Something else we don’t know is what percentage solution each of us is using. The more concentrated the solution (we have a choice of 1.5, 2.5 and 4.25%), the higher the expected microfiltration.
My prescription has me on dwell for a total of 4 times 120 minutes or 480 minutes, while “him” is on dwell for a total of 5 times 90 minutes or 450 minutes. So I have fluid in my stomach for 30 more minutes, all else being equal. This is where things get a little bit more complex to describe and understand.
There is a concept in peritoneal dialysis called Transport, and Transport is measured by something called PET. To help explain these concepts, I turned to Poe with the following result:
Poe Assistant:
In peritoneal dialysis, the transport level refers to the permeability of the peritoneal membrane to solutes during the dialysis process. The peritoneal membrane acts as a semi-permeable barrier between the blood vessels and the dialysis solution (dialysate) that is infused into the peritoneal cavity. The transport level is determined by the characteristics of the peritoneal membrane, which can vary from person to person. There are three main types of transport levels in peritoneal dialysis:
High Transporters: High transporters have a peritoneal membrane that is highly permeable to solutes. This means that solutes, such as waste products and excess fluid, can easily pass through the membrane from the blood vessels into the dialysate. High transporters may require more frequent or longer dwell times during peritoneal dialysis to adequately remove waste products.
Low Transporters: Low transporters have a peritoneal membrane that is less permeable to solutes. In these individuals, the removal of waste products and excess fluid during peritoneal dialysis may be less efficient. Low transporters may require longer dwell times or more exchanges to achieve adequate dialysis.
Medium Transporters: Medium transporters have a peritoneal membrane with intermediate permeability. Their peritoneal membrane allows for a moderate transfer of solutes between the blood vessels and the dialysate.
The transport level is assessed using a test called the peritoneal equilibration test (PET). This test involves measuring the concentrations of certain solutes in the dialysate at different time points during a dwell period. The results of the PET help determine the transport level of an individual and guide the prescription of peritoneal dialysis.
By tailoring the peritoneal dialysis prescription to an individual’s transport level, healthcare providers can optimize the effectiveness of dialysis treatment and improve patient outcomes.
I have what is considered to be a LOW TRANSPORT peritoneal membrane. Without knowing what “his” transport is, we can’t compare “his” dwell times or total times to mine. If we did, it would be comparing apples to oranges and we don’t want to be guilty of that, do we?
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