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
- William L Henrich, MD, MACP
William L Henrich, MD, MACP
- Professor of Medicine
- President of the Health Science Center
- University of Texas Health Science Center School of Medicine
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. The following parameters are generally used to guide treatment:
●Total solute clearance
●Residual renal function
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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