A clinical study of 2.5 liter exchange volumes

Comparisons of peritoneal clearances, hematologic and biochemical assays were performed on eleven CAPD patients using 2 liter and 2.5 liter daily exchanges. Group 1 consisted of 8 patients substituting all four daily 2 liter exchanges. These patients experienced statistically significant increases in urea and creatinine clearance (an average of 15% and 10% respectively). Corresponding reductions in serum levels occurred (8% and 9% respectively). Ultrafiltrate volume increased by an average of 12%. Group II consisted of 3 patients that substituted one 2 liter exchange. These patients also experienced increases in urea and creatinine clearance (8% and 11% respectively) and decreases in corresponding serum levels (1% and 4% respectively). Ultrafiltrate volume increased an average of 12%. After one month on the 2.5 liter regimen, patients were surveyed for their reactions to larger exchange volumes. Ninety-one percent of patients decided to continue using the 2.5 liter volume. Reasons cited included feeling better and having better weight and fluid control. None of the patients demonstrated complications such as catheter leakage or hernias. The use of four daily 2.5 liter exchanges can provide over 20% more clearance for many CAPD patients currently using 2 liter exchanges. This survey demonstrates most patients tolerate 2.5 liters, and they feel better. A 2.5 liter regimen may be indicated for patients who could benefit from more dialysis and for those at risk of dropping out of CAPD due to inadequate dialysis.