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Prof Narayan Prasad, Lucknow 27 December 2018

Guidelines for peritoneal equilibration test (PET) - First PET 4-6 weeks after peritoneal dialysis (PD) initiation; Repeat annually (ISPD guidelines); Early detection of change in PET characteristic; Modify prescription and close FU to avoid adverse outcomes.
Modified 4-hour PET - A 4-hour exchange; 4.25% dextrose dialysis solution; 2 liter fill volume; Upright position during dwell; 8-10 hours overnight pre-test exchange; Mid-test serum sample for Cr, GI and Na; 0 hour, 1-, 2- and 4-hour dialysate samples for Cr, GI and Na.
Information from 4.25% PET - Ultrafiltration volume: >400 mL adequate; D/P creatinine: >0.8 fast transporters, <0.6 slow transporters; Na sieving (∧Na), only if you drain at 1 hour: >5 mmol/L adequate, <5 mmol/L inadequate.
Mini-PET - 4.25% drained at 1 hour; quantifies free water transport; UF <100 mL suggests deficient free water clearance.
PET remains an important semi-quantitative assessment of PM characteristics; 4.25% PET with ∧Na assessment is the most useful single test.
PET at baseline and yearly can yield important and clinically relevant information. It helps in charting initial therapy and subsequent optimization of therapy. It has an important role in evaluating volume overload and patients with failing PD clearances.

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