PET Standard (Peritoneal Equilibrium Test)

The PET measures solute equilibration, the rate of glucose absorption and the net ultrafiltration. With these measures, the peritoneal membrane is classified as high transport, high average transport, low average transport or low transport. The membrane classification guides the prescription for the Peritoneal Dialysis (PD) patient. The test itself consists of a series of exchanges over 4 hours and an overnight exchange. 

Obtaining Patient Specimens and Overnight at Home Preparation

1. Instruct patient to perform a standard CAPD 8 – 12 hour overnight dwell on the evening prior to the test.
2. Prepare a 2 liter 2.5% dialysis solution bag and warm to body temperature.
3. With patient upright, drain overnight dwell over a 20 minute period and record volume drained.
4. With patient lying on back, infuse the fresh 2 liter 2.5% dialysis solution at a rate of 400 mL per 2 minutes (a total of exactly 10 minutes for 2 liters). Have the patient roll from side to side after each 400 mL of solution is infused (e.g., 2 minutes – 400 mL, 4 minutes – 800 mL, etc.). Record the time at which infusion is completed. This is the 0 Hour dwell time.
5. At 0 and 2 Hour dwell times, with patient lying down, collect dialysate specimen as follows:
   1. Use your facility’s protocol to clean/disinfect medication support.
   2. Drain 200 mL of fluid into drain bag.
   3. Mix the specimen by inverting bag 2 – 3 times.
   4. Attach Safety Needle to Holder.
   5. Remove green needle cover and insert needle into medication port.
   6. Insert a White Top Tube into the Holder and fill until flow ceases. Reinfuse the remaining fluid.
      
   7. Use the bar code label with patient’s name and ID to identify the specimen. Place the “0 Hour” and “2 Hour” labels on the correct specimens.
      
      
   8. Refrigerate at 2°- 8° C
6. At the 2 Hour dwell time, draw a blood specimen into a Green Top Tube for Creatinine, BUN and Glucose testing. If monthly panels are also required, they can also be drawn at the 2 Hour dwell.
   
7. Centrifuge the Green Top Tube.
   
8. At the 4 Hour dwell time, with patient in a vertical position, collect dialysate specimen as follows:
   1. Drain the exchange over 20 minutes.
   2. Mix the specimen by inverting the bag 2-3 times.
   3. Attach Safety Needle to Holder.
   4. Remove green needle cover and insert needle into medication port.
   5. Insert a White Top Tube into the Holder and fill until flow ceases. Reinfuse remaining fluid.
      
   6. Use the bar code label with the patient’s name and ID to identify the specimen. Place the “4 Hour” label on the correct specimen.
      
   7. Refrigerate at 2°- 8° C.
   8. Weigh the drain bag and record the volume.