Optimization of peritoneal dialysis prescription using computer models of peritoneal transport

Computer models are valuable clinical tools in the effort to improve quality of life for dialysis patients. At present, two software programs have been validated clinically in adult and pediatric populations. They are the Personal Dialysis Capacity (PDC: Gambro Lundia AB, Lund, Sweden) and PD Adequest (Baxter Healthcare Corporation, Deerfield, IL, U.S.A.). Both programs seem to give accurate predictions of small-solute clearance, but the PDC seems to be superior in predicting ultrafiltration volumes. Indeed, the software programs have several important differences that affect their accuracy and, hence, their clinical value. The PDC software introduces the concepts of capillary physiology to the field of peritoneal dialysis. It gives a functional description of the peritoneal membrane of the individual patient. Recently, its "new" area parameter (A0/delta x) was shown to be superior to the peritoneal equilibration test (PET) in predicting transperitoneal exchange.