Automated measurement of intraperitoneal pressure versus patient fill-volume

Abstract

Measuring intraperitoneal pressure (IPP) has been proposed as a means to help maintain optimal ultrafiltration and prevent complications such as hernias, peritoneal leaks, and gastroesophageal reflux, which are linked with high IPP levels. The Durand method is a commonly accepted method for measuring IPP; however, it is cumbersome and not routinely used in clinics due to its complexity. Here we report the outcome of a pilot study that evaluated the agreement between IPP measured using an in-line pressure transducer and IPP measured using the Durand method during in-clinic automated peritoneal dialysis (APD) therapy. This was an exploratory, descriptive, early feasibility study conducted among patients with a diagnosis of kidney failure who were on APD therapy. IPP was continuously measured using an investigational device (x-MIP transducer) and at fixed timepoints using the Durand method. The study included 10 patients with a median age of 47.0 years and a median body mass index of 28.1 kg/m². The study population was predominantly female, comprising 70% of the participants. The transducer IPP showed a moderate agreement with manual IPP, as most differences in measurements were within ±3 cmH₂O. Overall, IPP did not correlate with fill-volume. However, when examined on a per-patient level, six patients showed stronger correlations (ρ > 0.7) between IPP and fill-volume, while the remaining four patients had weaker correlations (ρ < 0.5). No safety concerns were identified in the study. In summary, this study indicates that a transducer-based IPP measurement device could serve as an alternative to the Durand method.