The effect of dialysate dwell on gastric emptying time in patients on continuous ambulatory peritoneal dialysis.

Methods And Patients: We evaluated gastric emptying time (GET) with a technetium (Tc) 99m-sulfur colloid gastric emptying scan in 11 patients on continuous ambulatory peritoneal dialysis (CAPD) (6 males, 5 females) and in 14 controls. We investigated the effect of dialysate dwell on GET by studying the subjects twice: once without dialysate in the abdomen (drained) and once with 2 L of dialysate in the abdomen (full). We also investigated the relationship between body surface area (BSA) and delayed gastric emptying.

Results: (1) The mean gastric emptying rate in 120 minutes in patients on CAPD when drained (67.8%+/-13.4%) was not different from that in controls (65.4%+/-8.6%). (2) The mean gastric emptying rate in 120 minutes in patients on CAPD when full was significantly slower than that when drained (55.6%+/-14.6% versus 67.8%+/-13.4%, p < 0.05). In four of the 11 patients (36.4%), gastric emptying was extremely delayed from normal to abnormal range when full. (3) The BSA of patients who had extremely delayed GET from normal to abnormal range was smaller than that of patients who had minimal delayed or unchanged GET when full (1.5+/-0.11 m2 versus 1.74+/-0.22 m2).

Conclusion: This study showed that patients on CAPD had normal gastric emptying when drained, and that gastric emptying was delayed by dialysate dwell, especially in patients who has less than 1.5 m2 of body surface area. Therefore, we suggest that, based on adequacy, intermittent nocturnal peritoneal dialysis or a small volume of dialysate be considered for patients with small body surface area.