Adequacy testing in peritoneal dialysis: a five years experience in a single dialysis center.

Abstract

An increasing number of patients is treated with peritoneal dialysis (PD). Adequacy testing in PD has gained wide interest because of its shown relation with morbidity and mortality. We describe retrospectively the 5 years follow-up (1993-1998) of adequacy testing of our PD patient population on 1 January 1998. We were used to change the PD regime if Kt/Vurea was < 1.7. On 1 January 1998 there were 57 patients on PD treatment (41 patients on CAPD, 16 on CCPD). The total PD group adequacy values are given on 1 January 1998. During the 5 years follow-up residual renal Kt/Vurea declined, from a mean value of 0.51 to zero. Mean values of total Kt/Vurea remained unchanged (2.01 at the start, 1.83 at 3 years, 1.91 at 5 years) as a consequence of an increase in peritoneal Kt/Vurea. We were able to maintain a reasonable dialysis adequacy in time by adjusting the total daily PD fluid amount, despite the total loss of residual renal function in 5 years. However, it will be difficult to reach the newest DOQI guidelines, especially in patients with total loss of their residual renal function and in patients with a larger body surface area.