Is there any literature to support not doing a 24 hour collection after peritonitis? I am reading about the PET and waiting for the four weeks post peritonitis but are the results of a 24 hour collection affected? Allyson

Questions About PD

Allyson Hoard-Mann, Nurse from TBRHSC asked
Is there any literature to support not doing a 24 hour collection after peritonitis? I am reading about the PET and waiting for the four weeks post peritonitis but are the results of a 24 hour collection affected? Allyson

2 answers

Nurse, Canada March 29, 2019

We thank you for your question. We are not quite sure of the reason you would wish to perform a 24-hour urine collection of a patient on PD after an episode of peritonitis, but will try to answer your question in general terms. We are also not aware of any literature specific on this topic. Waiting for 4 weeks to perform a PET was recommended in these early 2006 NKF K/DOQI guidelines (http://kidneyfoundation.cachefly.net/professionals/KDOQI/guideline_upHD_PD_VA/pd_rec3.htm ) Guideline 3.5 “All measurements of peritoneal solute clearance should be obtained when the patient is clinically stable and at least 1 month after resolution of an episode of peritonitis.” The reason being that peritonitis transiently changes the patient to a high transporter and decreases ultrafiltration per dextrose concentration used. Other guidelines follow this recommendation.
 
We would suggest that also it is best to wait until the patient on PD is clinically stable after an episode of peritonitis before performing a 24-hour urine collection. Not only may the peritoneal membrane change with peritonitis, resulting in a possible decrease in ultrafiltration, but also the patient will be on a specific course of antibiotics, possibly affecting urine output and appetite. Moreover, the patient will be recovering from an inflammatory response to the peritonitis.

#1
Neil Boudville - Australia 1 day ago

I concur, as the peritoneal membrane changes at the time of peritonitis (and may not return back to baseline) it will effect small solute clearance and UF volume.

#2

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