Continuous flow peritoneal dialysis: ideal peritoneal dialysis or second-rate hemodialysis?

Since the original description of continuous flow PD (CFPD) by Shinaberger, there has been interest in the utility of this modality to augment small solute clearances in those on PD.

The clinical and theoretical treatment of CFPD regimens and the changing views of small solute clearance and outcome in dialysis since the publication of several important randomized, controlled trials are reviewed.

There is little justification to promote CFPD solely on the basis of increased small solute clearance, given the lack of robust association between this measure and outcome in PD patients. Furthermore, leaving the abdomen empty between CFPD sessions may seriously compromise removal of middle molecular weight uremic toxins, one of the presumed strengths of conventional PD.