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Innovative peritoneal dialysis: flow-thru and dialysate regeneration
1Nephrology Department, Sepulveda VA Medical Center, California 91343, USA.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|September 30, 1999
Summary
Flow-through peritoneal dialysis (PD) and dialysate regeneration can significantly increase dialysis dose and clearances. This approach enhances waste removal for PD patients with declining renal function.
Area of Science:
- Nephrology
- Biomedical Engineering
- Renal Replacement Therapy
Background:
- Peritoneal dialysis (PD) dose must increase as residual renal function declines.
- Current PD methods have limited options for increasing dialysis dose.
- Increased dialysis dose is crucial for managing declining renal function in PD patients.
Purpose of the Study:
- To explore methods for significantly increasing dialysis dose in peritoneal dialysis.
- To evaluate the potential of flow-through PD and dialysate regeneration.
- To improve solute clearance and patient outcomes in peritoneal dialysis.
Main Methods:
- Literature review on flow-through PD and dialysate regeneration techniques.
- Analysis of studies using flow-through PD with and without regeneration.
- Examination of reported solute clearances (urea, creatinine) in advanced PD methods.
Main Results:
- Flow-through PD and/or dialysate regeneration substantially increase dialysis dose and clearances.
- Reported urea and creatinine clearances reached up to 58 and 48 ml/min, respectively.
- Regeneration allows high dialysate flow rates while minimizing total dialysate volume.
Conclusions:
- Flow-through PD with or without regeneration offers a significant increase in dialysis dose.
- Advanced PD techniques can achieve substantially higher solute clearances than standard PD.
- Sorbent regeneration may allow protein recovery, reduce protein loss, and enhance toxin removal.