Adequacy of Dialysis in Anuric CAPD Patiens

Background:Failure to achieve target values for both urea (Kt/V) and creatinine clearance has been associated with increased morbidity and mortality in CAPD patients. Current standard of adequacy CAPD is to provide a weekly normalized urea clearance of 2.0 or more and a creatinine clearance of 60 liter/ 1.73 or more. Conventional CAPD in patients without residual renal function is associated with worse clinical outcomes. This study was designed to study the effect of increasing daily exchange frequency on dialysis adequacy in anuric CAPD patients. Methods:The 27 anuric CAPD patients (patients on 4×2 L daily exchanges for 7 days) were selected and then they received standard dose dialysis (4x2 L daily exchanges for 7 days) followed by high dose dialysis (5×2 L daily exchanges). Weekly Kt/Vurea and weekly Ccr were measured at the end of standard and high dose dialysis. Adequate dialysis was defined as satisfying both weekly Kt/Vurea >2.0, weekly Ccr >60 L/1.73 according to DOQI guideline. Results:Selected patients were 12 men and 15 women, mean age was 4912 years, mean weight was 59.210.1 kg , mean peritoneal dialysis duration was 5115 months. Weekly Kt/V was 1.70.3 in standard dose dialysis patients and 2.10.4 in high dose dialysis patients, mean Ccr was 48.87.2 L/ week/1.73 in standard dose dialysis patients and 63.112.1 L/week/1.73 in high dose dialysis patients. This difference is statistically significant (p5.9 L vs 37.77.6 L) was significantly different (p