Measuring compliance with prescribed exchanges in CAPD and CCPD patients

Area of Science:

• Nephrology
• Renal Medicine
• Dialysis Therapy

Background:

• Peritoneal dialysis (PD) is a common renal replacement therapy.
• Patient compliance with prescribed dialysis exchanges is crucial for treatment efficacy.
• Assessing compliance in home-based PD can be challenging.

Purpose of the Study:

• To measure compliance with prescribed exchanges in continuous ambulatory peritoneal dialysis (CAPD) and continuous cycling peritoneal dialysis (CCPD) patients.
• To evaluate the reliability of the measured to predicted (M/P) creatinine ratio in predicting PD compliance.
• To investigate the effect of creatine intake on creatinine excretion.

Main Methods:

• Prospective analysis at a university dialysis center involving 20 home PD patients.
• Compliance assessed via home visit supply inventories over a 4-8 week period.
• Creatinine levels in dialysate and urine measured over three consecutive days, with dietary intake recorded.

Main Results:

• Home visit inventories indicated 40% of patients were noncompliant, performing only 75% of prescribed exchanges.
• No significant difference in M/P creatinine ratios between compliant and noncompliant patients.
• M/P ratios showed no significant variation over three days and did not correlate with dietary protein intake.

Conclusions:

• A significant portion of PD patients exhibit noncompliance with prescribed exchanges, highlighting a common and serious issue.
• The M/P creatinine ratio is unreliable for predicting PD compliance.
• Home visit inventories are recommended for assessing PD patient compliance.