A prescription model for peritoneal dialysis

The authors have developed a mathematical model for peritoneal dialysis, based on the Popovich-Pyle-Moncrief approach, that is capable of predicting urea Kt/V and total weekly creatinine clearance for a variety of peritoneal dialysis therapies. This prescription model incorporates both diffusive and convective solute removal as well as ultrafiltration and lymphatic absorption. The primary input to the model is a single peritoneal equilibration test. Twenty-four hour dialysate collection is not required. Results from an extensive prospective clinical study performed with 100 patients at five dialysis centers indicate that the model is valid for predicting urea Kt/V and creatinine clearance for continuous ambulatory peritoneal dialysis and continuous cycling peritoneal dialysis. Predicted clearances agree with the clinical data from these patients to within an average difference of approximately 10%. This model promises to be a powerful tool to assist nephrologists in quantifying the amount of peritoneal dialysis delivered by a given prescription, tailoring it to individual patient needs, and investigating the potential efficacy of a variety of alternative therapies.