There is large inter-individual var

There is large inter-individual variation in the rapidity of biochemical equilibration across
the peritoneal membrane. ‘Rapid transporters’ achieve early equilibration, can run into
problems with fluid overload because of the rapid loss of an osmotic gradient and
absorption of the dialysate into the circulation, and are sometimes better treated with
automated peritoneal dialysis or with Icodextrin. ‘Slow transporters’ may not achieve
adequate biochemical control unless treated with very high volume exchanges. Transport
status is determined 6-8 weeks after starting peritoneal dialysis by performance of a
“Peritoneal Equilibration Test” (“PET”). This test is performed in the renal Outpatient
department and involves instillation of a medium strength bag for 4h. Dialysate samples
are obtained at 0,2 and 4h and blood samples at 4h, allowing assessment of the ratio of
peritoneal:plasma creatinine and the initial:final dialysate glucose. Results of the PET
may be used to determine dialysis prescription.