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

Background: 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. Methods: 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/V-urea was < 1.7. Results: 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/V-urea declined, from a mean value of 0.51 to zero. Mean values of total Kt/V-urea 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/V-urea. Conclusions: 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. (C) 1999 Elsevier Science B.V. All rights reserved.