A description of the delivery of peritoneal dialysis (PD) in the US.
ASN 30th Annual Meeting, San Antonio
J Am Soc Nephrol (Sep) 8:278A 1997
As part of USRDS Dialysis Mortality and Morbidity Study Wave 2, this study considers a random sample of 1,862 patients who initiatied peritoneal dialysis during 1996. APD patients were 32% of the study group with NIPD 7%, CCPD 21.6% and APD plus (1 or more daytime exchanges) 3.4%. There were less APD treatments among Asian and older patients. The median dialysate total volume per day was: CAPD 8.2 L, NIPD 10.6 L, CCPD 11 L and APD plus 11.6 L. The median total weekly normalized creatinine clearance was 71.1 L (26.8 L renal, 43.4 L peritoneal) in CAPD and 70.1 L (29.4 L renal, 41.9 L peritoneal) in APD. The median total weekly urea Kt/V was 2.36 (0.69 renal, 1.63 peritoneal) in CAPD and 2.62 (0.74 renal, 1.73 peritoneal) in APD. Compared to 1986 USRDS data there is a notable increase in APD use and CAPD dialysate volume prescription. In 1996 the majority of patients reached an adequate dialysis dose following NKF-DOQI recommendations.
Comment: Thanks to improved knowledge of peritoneal dialysis adequacy due to recent studies, peritoneal dialysis prescription has changed in the US. Total dialysate volume and fill volume are increased, APD treatments are widely used and new (raised) adequacy targets are in use. These targets can be easily reached when the patients have a considerable residual renal function. When the patients become anuric there are more prescription problems especially in large patients. The possibility of prescribing adequate peritoneal dialysis has to be checked with kinetic modeling software and direct dialysis quantification. (Gianpaolo Amici, M.D., Treviso, Italy).
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ASN 30th Annual Meeting, San Antonio
Basic peritoneal dialysis : Chronic PD regimens, adequacy, modeling