Glucose Infusion Test (GIT): Un nuovo test per la valutazione del ricircolo in dialisi

Translated title of the contribution: Glucose Infusion Test (GIT): A new test for access recirculation detection

A. Magnasco, S. Alloatti, P. Solari

Research output: Contribution to journalArticlepeer-review

Abstract

Vascular Access Recirculation (AR) is an important cause of diminished dialysis efficiency. We propose a new screening test based on glucose infusion as a tracer for AR. The protocol of GIT includes a basal blood sample (A) from the arterial port, a 5 mL bolus of glucosate 20% into the venous chamber (time 0) followed by a second sample (B) withdrawal in 4 sec. (from 13°to 17°s if Q(B) = 300 mL/min) from the previous port. The blood glucose level is determined at the bedside on A and B by an accurate reflectance photometer (CV 1.8%). The interpretation of the test is straightforward: if B = A there is no AR, while if B > A, AR can be calculated from the regression equation AR = 0.046 x (B-A) + 0.07, obtained by in vitro tests reproducing artificial AR of 0-5-10%. To validate this new method in vivo, we compared the GIT to the Urea test (UT) in 33 hemodialysis patients (pts). The two tests were considered positive when the confidence intervals of the elements of formulae S and A for UT; B and A for GIT did not overlap. By this analysis we can distinguish three groups of pts. In group A (12/33 pts) AR(GIT) was absent (0.07%±0.1) and near to zero while UT was negative but inaccurate (AR(UT) 1.3% ± 2.3). In group B (14/33) both GIT and UT detected AR with respective values of 18.0%±9.2 and 21.4%±9.4. The last group C includes 7 pts with positive AR(GIT) (5.0% and mean value of B-A = 107 mg/dL) while AR(UT) (5.5%) was not statistically different from zero because of the overlap of S and A (mean value of S-A = 5.8 mg/dL). In conclusion, the GIT proved to be more sensitive (detection limit <1% rather than

Translated title of the contributionGlucose Infusion Test (GIT): A new test for access recirculation detection
Original languageItalian
Pages (from-to)94-100
Number of pages7
JournalGiornale italiano di nefrologia : organo ufficiale della Società italiana di nefrologia
Volume16
Issue number1
Publication statusPublished - 1999

ASJC Scopus subject areas

  • Nephrology

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