Clinical Validation of a Peritoneal Dialysis Prescription Model in the PatientOnLine Software

Hodzic, Emir; Rasic, Senija; Klein, Christian; Covic, Adrian; Unsal, Abdulkadir; Cunquero, José Manuel Gil; Prischl, Friedrich C.; Gauly, Adelheid; Kalicki, Robert M.; Uehlinger, Dominik E. (2015). Clinical Validation of a Peritoneal Dialysis Prescription Model in the PatientOnLine Software. Artificial organs, 40(2), pp. 144-152. Wiley-Blackwell 10.1111/aor.12526

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Peritoneal transport characteristics and residual renal function require regular control and subsequent adjustment of the peritoneal dialysis (PD) prescription. Prescription models shall facilitate the prediction of the outcome of such adaptations for a given patient. In the present study, the prescription model implemented in the PatientOnLine software was validated in patients requiring a prescription change. This multicenter, international prospective cohort study with the aim to validate a PD prescription model included patients treated with continuous ambulatory peritoneal dialysis. Patients were examined with the peritoneal function test (PFT) to determine the outcome of their current prescription and the necessity for a prescription change. For these patients, a new prescription was modeled using the PatientOnLine software (Fresenius Medical Care, Bad Homburg, Germany). Two to four weeks after implementation of the new PD regimen, a second PFT was performed. The validation of the prescription model included 54 patients. Predicted and measured peritoneal Kt/V were 1.52 ± 0.31 and 1.66 ± 0.35, and total (peritoneal + renal) Kt/V values were 1.96 ± 0.48 and 2.06 ± 0.44, respectively. Predicted and measured peritoneal creatinine clearances were 42.9 ± 8.6 and 43.0 ± 8.8 L/1.73 m2/week and total creatinine clearances were 65.3 ± 26.0 and 63.3 ± 21.8 L/1.73 m2/week, respectively. The analysis revealed a Pearson's correlation coefficient for peritoneal Kt/V of 0.911 and Lin's concordance coefficient of 0.829. The value of both coefficients was 0.853 for peritoneal creatinine clearance. Predicted and measured daily net ultrafiltration was 0.77 ± 0.49 and 1.16 ± 0.63 L/24 h, respectively. Pearson's correlation and Lin's concordance coefficient were 0.518 and 0.402, respectively. Predicted and measured peritoneal glucose absorption was 125.8 ± 38.8 and 79.9 ± 30.7 g/24 h, respectively, and Pearson's correlation and Lin's concordance coefficient were 0.914 and 0.477, respectively. With good predictability of peritoneal Kt/V and creatinine clearance, the present model provides support for individual dialysis prescription in clinical practice. Peritoneal glucose absorption and ultrafiltration are less predictable and are likely to be influenced by additional clinical factors to be taken into consideration.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Unit Childrens Hospital > Forschungsgruppe Nephrologie / Hypertonie
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Nephrology and Hypertension

UniBE Contributor:

Kalicki, Robert and Uehlinger, Dominik

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0160-564X

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Dominik Uehlinger

Date Deposited:

11 Feb 2016 10:18

Last Modified:

11 Feb 2016 10:18

Publisher DOI:

10.1111/aor.12526

PubMed ID:

26147618

BORIS DOI:

10.7892/boris.75422

URI:

https://boris.unibe.ch/id/eprint/75422

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