PRELIMINARY ASSESSMENT OF DRAIN VOLUME
Careful assessment of patient parameters during the training period is essential. Volume of urea distribution and residual kidney function can easily be determined; however, accurate assessment of peritoneal transport type is more difficult due to inflammatory changes that may occur during the first month.* Therefore, during training, careful assessment of drain volumes following a 4-hour dwell using 2.5% dextrose and 2.0 L fill volume can help in estimating transport properties.4
Unless a preliminary PET is performed, the initial prescription should be based on assumptions of average membrane type. Initial membrane assessment and ultrafiltration response to dextrose: Use 2.5% dextrose, 2.0 L fill volume and at 4 hours, assess drain volume to crudely estimate membrane transport type.32
| MEMBRANE TRANSPORT TYPE | DRAIN VOLUME* |
|---|---|
| HIGH | 1580-2084 mL |
| HIGH-AVERAGE | 2085-2367 mL |
| LOW-AVERAGE | 2369-2650 mL |
| LOW | 2651-3326 mL |
* Mean for all transport types is 2368 mL
Note: In diabetic patients with high serum glucose levels (>300 mg/dL), the results of the drain volume are not useful for patient categorization and inconsistent with creatinine values.32