Adequacy in peritoneal dialysis

Peritoneal dialysis (PD) adequacy is usually estimated by parameters based on the kinetics of small solutes as total Kt/V(urea) and total weekly creatinine clearance. However, other aspects (blood pressure, anemia, nutrition, inflammation, mineral metabolism and prevention of cardiovascular events) and, in particular, residual renal function must be taken into account. Although minimal levels are well defined, there are no optimal targets to be achieved. Clinical assessments are more and more relevant. In addition, fluid and sodium removal must be estimated, several studies showing that even in an uric patients adequacy can be obtained. Nutrition and inflammation have to be evaluated and their role seems to be more important than peritoneal membrane status in patient survival. Guidelines and recommendations are available to provide a better follow-up in patients on PD.