Prescribing and assessing adequate peritoneal dialysis
- John M Burkart, MD
John M Burkart, MD
- Section Editor — Dialysis
- Professor of Medicine/Nephrology
- Wake Forest University Medical Center
Peritoneal dialysis patient outcomes are affected by the amount of peritoneal dialysis performed and by the amount of residual renal function present. This topic reviews the optimal peritoneal dialysis dose and the determination and preservation of residual renal function.
The assessment of decreased solute clearance and ultrafiltration is discussed elsewhere. (See "Problems with solute clearance and ultrafiltration in continuous peritoneal dialysis" and "Peritoneal equilibration test".)
The optimal amount of peritoneal dialysis that should be performed is not known. Observational studies and at least two prospective, randomized clinical trials have evaluated clinical outcomes in patients who were prescribed the "standard" dose of dialysis compared with those with a "higher" dose of dialysis [1,2]. Based on these data, the following parameters are generally used to guide treatment:
●Small solute clearance (using Kt/V as the surrogate)
●Residual renal functionTo continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- SOLUTE CLEARANCE
- Solute clearance provided by peritoneal dialysis
- Solute clearance provided by residual renal function
- Target Kt/Vurea
- - Chronic ambulatory peritoneal dialysis
- - Automated peritoneal dialysis
- Evaluation of patients with low delivered Kt/V
- Frequency of monitoring
- CONTROL OF UREMIC SYMPTOMS, MINERAL METABOLISM, AND ELECTROLYTES
- FLUID BALANCE
- PRESERVATION OF RESIDUAL RENAL FUNCTION
- PATIENT COMPLIANCE
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS