Nightly intermittent peritoneal dialysis: targets and prescriptions

Adequate peritoneal dialysis can be achieved in most ESRD patients, provided that the prescription is individualized according to body surface area, body weight, residual renal function, and peritoneal transport characteristics. NIPD is particularly indicated in patients with significant residual renal function or those with a high-transport peritoneal membrane (accounting for about 10% of the PD patient population). "Dry day" NIPD reduces small-solute clearance by at least 10%-15% and middle-molecule clearance by almost 50%. Thus, most NIPD patients without residual renal function are at risk of inadequate treatment. The target dose of NIPD should be a weekly Kt/V of at least 2.2 and a weekly total creatinine clearance of 66 L/1.73 m2. However, the periodic clinical evaluation of patients should have priority over the mere achievement of a numerical clearance target.