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Published on: July 19, 2018
Past, present, and future of quantified peritoneal dialysis
1Division of Nephrology, Department of Medicine, MA436 Health Sciences Center, University of Missouri, Columbia, MO 65212, USA.
Seminars in Dialysis
|August 8, 2001
Summary
Peritoneal dialysis (PD) has evolved significantly, with advancements like continuous ambulatory PD (CAPD) improving renal replacement therapy. Adequacy assessments, such as Kt/V, are crucial for effective PD treatment in end-stage renal disease.
Area of Science:
- Nephrology
- Renal Replacement Therapy
- Dialysis Technology
Background:
- Peritoneal dialysis (PD) was historically a last resort for uremia treatment.
- The development of chronic indwelling catheters enabled long-term PD.
- Continuous ambulatory peritoneal dialysis (CAPD) revolutionized PD practices.
Purpose of the Study:
- To review the evolution of peritoneal dialysis (PD).
- To emphasize the importance of PD adequacy in renal replacement therapy.
- To discuss recent advancements and future directions in PD.
Main Methods:
- Review of historical data and advancements in PD.
- Emphasis on adequacy metrics like Kt/V and creatinine clearance.
- Discussion of guidelines (NKF-DOQI) and studies (CANUSA).
Main Results:
- Adequacy assessment using Kt/V and creatinine clearance is vital.
- Standardized peritoneal equilibration tests enhance PD efficiency.
- NKF-DOQI guidelines established minimum PD adequacy criteria.
Conclusions:
- PD has evolved from a last resort to a well-established renal replacement therapy.
- Adequacy, compliance, and early initiation ('healthy start') are key to PD efficacy.
- Continuous flow PD (CFPD) represents a recent innovation, with PD's role continuing to evolve.
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