PET Testing has Utility in the Prescription of Peritoneal Dialysis: CON

What is it about?

A healthy and functional peritoneal membrane is key to achieve sufficient ultrafiltration and maintain fluid balance, a major component of a high-quality prescription in patients treated with peritoneal dialysis (PD).A key tool for assessment of peritoneal membrane transport characteristics is a 4-h peritoneal equilibration test (PET). Currently the monitoring of peritoneal transport is part of the routine of many PD units and the results of PET are used to both help guide PD prescription and even to prognosticate. Should PD really be prescribed using the PET? The PET, like many other diagnostic tests, has limitations to its validity and accuracy. It is clear that PD can be appropriately prescribed without a PET, based solely on clinical assessment and knowledge of residual kidney function. Individualized prescriptions should align with the patients’ day-to-day needs, moving away from the rigid, time-consuming and surprisingly inaccurate measurements of transport characteristics of the peritoneal membrane.

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