The 2006 K/DOQI guidelines for peritoneal dialysis adequacy are not adequate

The 2006 National Kidney Foundation K/DOQI guidelines have lowered the peritoneal dialysis adequacy standard of Kt/V(urea) from 2.1 to 1.7 in anuric patients, largely based on the patient survival results of 2 clinical trials in Mexico and Hong Kong. It is our contention that the guidelines may be misleading since they have chosen to ignore the bias in these trials and have ignored the adverse outcomes in control groups in the trials on which the guidelines are based, as well as the body size of the subjects in these trials. Body size has changed in the US and Canada over the last few decades and there are similar changes worldwide. We suggest that the minimum targets for peritoneal dialysis be reinstituted at the previous standard Kt/V(urea) of 2.0.