How to Assess the Dose of Peritoneal Dialysis
1. An appropriate peritoneal dialysis (PD) prescription, tailored to the patient’s peritoneal membrane transport, is imperative for optimal clinical outcome.
2. Although determination of dry weight is challenging for any patient, observational analyses have demonstrated that enhanced ultrafiltration (UF) in patients treated with PD is associated with improved survival. Peritoneal UF and sodium removal using icodextrin (Extraneal) has been shown to be superior compared to dextrose-based solutions.
3. Residual kidney function is strongly associated with survival advantage for patients receiving both peritoneal and hemodialysis. As such, strong attention should be paid to protecting kidney function for all patients on dialysis.
4. Icodextrin used as a cornerstone to the initial PD prescription simplifies the PD prescription for both patients and prescribers and minimizes the impact of patient membrane transport type on UF and sodium removal.