Determination of Peritoneal Membrane Transport Characteristics with Dialysis Adequacy and Transport Test in Thai Patients
Charoen Kaitwatcharachai MD*, Jaruda Aden MSc**, Khamanut Kongkid BNS***, Tharntip Kitpiboonchai MSN***, Somthawil Kaitwatcharachai BNS***
Affiliation : * Division of Medicine, Hat Yai Hospital, Songkhla, Thailand ** Division of Pathology, Hat Yai Hospital, Songkhla, Thailand *** Division of Nursing, Hat Yai Hospital, Songkhla, Thailand
Objective : The characteristics of peritoneal membrane transport are useful for the determination of dialysis treatment
prescription. The peritoneal equilibration test (PET) is accepted as a gold standard tool for identification of these characteristics.
Unfortunately, the process of PET is troublesome and unsuitable for clinical practice. Dialysis adequacy and transport test
(DATT), which is easier and more convenient method, is proposed as an alternative test. The aim of the present study was to
evaluate the accuracy of the DATT in determination of membrane characteristics in Thai patients.
Material and Method: Fifteen patients underwent both DATT and PET on the same day. The second DATT was performed.
The 24-hour dialysate-to-plasma ratio of creatinine (D/Pcr) from each DATT was compared with the adjusted 4-hour D/Pcr
from the corresponding PET. The types of membrane solute transport were classified using the PET proposed by Twardowski
and the DATT suggested by Rocco into high, high average, low average, and low transporter.
Results : The mean age was 48.1 + 16.4 years. The mean value of D/Pcr derived from DATT was higher than PET (0.80 +
0.10 vs. 0.74 + 0.14). The results of both D/Pcr were correlated (r = 0.78, p = 0.001). However, determinations of
characteristics of membrane transport were discordant (kappa coefficient = 0.25). The results of the repeated D/Pcr were not
different and the classification of membrane transport properties were concordant (kappa coefficient = 0.68).
Conclusion : The results of D/Pcr derived from both tests were correlated. However, determinations of characteristics of
membrane transport were discordant.
Keywords : Dialysis adequacy and transport test, Peritoneal equilibration test, PET, CAPD
