Individualized prescription of peritoneal dialysis therapy?

Prescribing PD has become more challenging, but also more rewarding and stimulating in recent years. The number of technical aids and strategies has increased, and a potential exists to optimize clearances and ultrafiltration in a way that has not been seen before and that will, it is to be hoped, translate into better patient outcomes. It is crucial, however, that the technologies and strategies be applied with an awareness of the individual patient's particular lifestyle, aspirations, and social circumstances. A failure to consider these factors may lead to noncompliance and, ultimately, to "burnout" and technique failure. Patients must be educated about the importance of clearance targets so that they will accept the alterations in, or the onerous aspects of, the prescriptions they require. Successful prescribing of PD requires an awareness of both clearance and lifestyle factors so that the two can be integrated to give an effective and acceptable regimen. Finally, cost factors should also be considered.