The economics of peritoneal dialysis: a cost-efficiency study

To determine the maximum possible return of urea extracted per litre of peritoneal dialysis fluid used, nine test exchanges using volumes of 1, 1.5, and 2 litres of fluid for periods of 0.5, 1, and 1.5 h, were studied in 15 consecutive peritoneal dialyses. The actual quantity of urea extracted was estimated. On comparison, it was found that the best return was achieved with 1-litre volumes used for 1.5 or 1 h (80.65 +/- 5.58 and 80.18 +/- 5.13% respectively of a possible best of 100%) the difference between these being insignificant. All other exchange volumes and times used yielded significantly worse results. We recommend the use of 1-hour, 1-litre exchanges in peritoneal dialysis, except in patients who are in a hypercatabolic state, in whom we would use haemodialysis or 0.5 h 2-litre exchanges of peritoneal dialysis.