Re-evaluation of adequate dose in Japanese peritoneal dialysis patients

Our objective in the present study was to evaluate the dialysis dose required to maintain Japanese peritoneal dialysis (PD) patients in good condition. From 32 local hospitals, we selected 100 stable patients without diabetes mellitus who were on continuous ambulatory peritoneal dialysis (CAPD) or automated peritoneal dialysis (APD), and we performed the peritoneal function test using the newly developed PD NAVI software (JMS, Hiroshima, Japan). Weekly total Kt/V and creatinine clearance (CCr) were calculated and plotted against body weight (BW) to evaluate the PD dose. In CAPD patients (n = 58), we found an inverse linear correlation between total Kt/V and BW (r = -0.576). In the same patients, total Kt remained essentially constant (60 L/week). Those results imply that most patients were being treated with the same PD regimen (2 L, 4 times daily), and that smaller patients were generally receiving a greater PD dose relative to body size than were the larger patients. In APD patients (n = 21), total Kt/V and total CCr normalized to 1.73 m2 did not change with BW. Total Kt and non normalized CCr gradually increased with BW, although the correlation was not significant. Those findings suggest that most APD patients received prescriptions that were more closely based on body size. In conclusion, smaller patients generally receive a greater PD dose than do larger patients, and targeting a single value of Kt/V or CCr may not always be relevant for adequate dialysis.