Peritoneal equilibration scores tied to dialysate-to-plasma folate levels in adults on PD
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Key takeaways:
- Plasma folate levels decreased with increase in peritoneal equilibration grades.
- Researchers found a positive link between dialysate-to-plasma folate and peritoneal equilibration grades.
Peritoneal equilibration test scores may be associated with dialysate-to-plasma folate concentration levels in adults on peritoneal dialysis, according to a published study.
The peritoneal equilibrium test assesses plasma creatinine and glucose transport.
“Lower plasma folate levels have been reported during PD than during [hemodialysis] HD,” Yu-Ling Lin, MD, MS, of the nephrology division in the department of internal medicine at Hsinchu Cathay General Hospital in Taiwan, wrote with colleagues. “In clinical practice, plasma folate level is not always constant and varies among individuals.”
Researchers recruited 50 patients with end-stage renal disease who underwent PD for at least 3 months and categorized the patients by peritoneal equilibration grades. Patients were also grouped by peritoneal equilibration test score. Dialysate-to-plasma creatinine ratios between 0.34 and 0.5 were considered low. Scores between 0.5 and 0.65; 0.65 and 0.8; and 0.81 and 1.03 were low-average, high-average and high, respectively.
The goal was to evaluate plasma folate levels and folate transport during PD.
Plasma folate levels and dialysate-to-plasma folate concentration ratio varied significantly across the four peritoneal equilibration groups, according to the study results.
For plasma folate levels, scores for each group were:
- low: 14.37 ng/mL;
- low-average: 6.79 ng/mL;
- high-average: 4.04 ng/mL; and
- high: 4.14 ng/mL
For dialysate-to-plasma folate concentration, scores were:
- low: 0.10;
- low-average: 0.21;
- high-average: 0.41; and
- high: 0.50
Test scores showed a significant negative correlation with plasma folate levels, with levels decreasing with a peritoneal equilibration increase. Researchers also noted a positive link between dialysate-to-plasma folate and peritoneal equilibration grades.
“These outcomes provide evidence that folate supplements are underused in clinical practice,” Lin and colleagues wrote. “Physicians should evaluate plasma folate levels more aggressively to high-transport PD patients instead of waiting till the patients present with low plasma folate levels. Further studies are warranted to confirm our findings.”
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