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      Delivered Dialysis Dose with PD Plus Therapy


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          Aim: To evaluate the effect of PD Plus on weekly Kt/V<sub>urea</sub> and creatinine clearance (K<sub>cr</sub>) among patients undergoing CAPD/CCPD (continuous ambulatory peritoneal dialysis/continuous cyclic peritoneal dialysis). Methods: The kinetic studies of 92 CAPD and 18 CCPD patients who transferred to PD Plus were analyzed. All patients underwent CAPD/CCPD and PD Plus for a minimum of 3 months. Standard collection methods were used and kinetic indices calculated with the Pack PD Kinetic Modeling program. 57 patients had transport data and were modeled for a target weekly Kt/V<sub>urea</sub> ≥2.1 using PD Plus with ≤15 liters dialysate/day. 6 patients were supervised during the collection periods by research nurses. The actual results for all patients (110) and for the supervised patients were compared against the modeled results. Results:45% of the patients achieved a Kt/V<sub>urea</sub> ≥2.1 and 47% a K<sub>cr</sub> ≥60 liters/1.73 m<sup>2</sup> with PD Plus, but only 20% did so with CAPD/CCPD. A close correlation between the supervised patients and modeled therapy was observed. Conclusions: Adequate dialysis is possible by using higher fill volumes, the supine position, and optimal dwell times (PD Plus) in most patients. The discrepancy between modeled and achieved dose is likely due to poor compliance with therapy, inadequate training, or poor specimen collection.

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          Author and article information

          Am J Nephrol
          American Journal of Nephrology
          S. Karger AG
          December 1998
          09 December 1998
          : 18
          : 6
          : 520-524
          a Fresenius Medical Care – North America, Peritoneal Dialysis Services, and b Fresenius USA Therapy Support Program, Walnut Creek, Calif., USA
          13398 Am J Nephrol 1998;18:520–524
          © 1998 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Figures: 3, Tables: 2, References: 14, Pages: 5
          Self URI (application/pdf): https://www.karger.com/Article/Pdf/13398
          Self URI (text/html): https://www.karger.com/Article/FullText/13398
          Self URI (journal page): https://www.karger.com/SubjectArea/Nephrology
          Clinical Study

          Cardiovascular Medicine,Nephrology
          Dialysis adequacy,Peritoneal dialysis,Dialysis dose,Therapy enhancement


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