Abstract: SA-PO467
Defining the Optimal Frequency of Dialysis Adequacy Test for Patients on Peritoneal Dialysis
Session Information
- Home Dialysis - 2
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Ng, Jack Kit-Chung, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- Fung, Winston Ws, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- Szeto, Cheuk-Chun, The Chinese University of Hong Kong, Hong Kong, Hong Kong
Background
Peritoneal Dialysis (PD) is a cost-effective treatment for end-stage kidney disease, with the adequacy of small solute clearance being a key factor in determining the PD regimen. Although regular monitoring of small solute clearance is recommended, recent guidelines emphasize a person-centered approach. We hypothesize that peritoneal Kt/V(urea) remains stable in most patients and does not require frequent monitoring.
Methods
We reviewed 11427 PD adequacy tests in 1874 PD patients. The serial change in Kt/V-PD was compared. The effect of daily exchange volume, peritonitis episodes, PD solution osmolality, duration of dialysis, and other baseline parameters were explored.
Results
The median duration between two dialysis adequacy tests was 7.0 months (IQR 5.6 to 11.0 months). The average change in Kt/V-PD between two tests was 0.024 ± 0.319. The change in Kt/V-PD was significantly higher after an increase in exchange volume than those with a static PD exchange volume (0.176 ± 0.453 vs 0.012 ± 0.302, p<0.0001). When dialysis adequacy test pairs that had a static PD exchange volume were analyzed, the change in Kt/V-PD did not differ between tests that were interposed with peritonitis episodes and those without (0.006 ± 0.317 vs 0.013 ± 0.300, p = 0.4). The change in Kt/V-PD was similar when the adequacy test was repeated after an increase in PD solution osmolality as compared to those with a static PD regimen (-0.011 ± 0.367 vs 0.014 ± 0.296, p = 0.1). There was no correlation between the change in Kt/V-PD and the duration between two adequacy tests (r = 0.002, p = 0.8).
Conclusion
Our result shows that Kt/V-PD remains stable in most patients within 12 months and does not require frequent monitoring.