Standard continuous ambulatory peritoneal dialysis therapy provides similar initial T-Kt/V regardless of the patient s peritoneal membrane transporter category: Single-center experience

Patients on continuous ambulatory peritoneal dialysis (CAPD) are routinely evaluated using the peritoneal equilibrium test (PET) to determine the best method for achieving target total dialysis clearance (T-Kt/V). In this study,we tested the hypothesis that standard CAPD prescription would achieve an initial T-Kt/V of more than 1.7 in all the patients regardless of their PET measurements. This is a retrospective study that included patients who started standard CAPD of four two-liter exchanges per day. The study included 118 patients; their mean age was 51.5 years with a standard deviation (SD) of 14.39 years. There were 83 males (70.3%) and 35 females (29.7%). PET and Kt/V were performed during the first four to six weeks of the study. The PET classified the patients into four categories: 24 (20.3%),high transporters; 65 (55.1%),high average; 28 (23.7%),low average; and one (0.8%),low transporter. Patients were then divided in two groups: Group 1 comprised of the high transporters while Group 2 included all the other patients. The T-Kt/V of the two groups was similar; in Group 1,it was 2.57 (± 1.17) and in Group 2 it was 2.50 (± 0.88) (P = 0.77). The T-Kt/V of patients with no residual renal function was also similar; in Group 1 and Group 2 it was 1.8 (± 0.29) and 1.97 (± 0.56),respectively (P = 0.45). All patients in our study who started on standard CAPD treatment had an adequate initial T-Kt/V. Thus,our data demonstrate that all patients with end-stage renal disease can safely begin standard CAPD without PET,which only needs to be performed if the patient encounters trouble in his/her T-Kt/V or fluid removal.