Assumptions on which Modeling is Based

Data from 1,006 randomly selected adult PD patients from 39 U.S. centers were analyzed and used to group patients according to their peritoneal membrane transport characteristics and V_urea. Based on four PET classifications and three V_urea categories, modeling was performed on PD Adequest to obtain prescriptions that would meet or exceed minimum adequacy and UF goals.¹¹

Clearance goals have been subject to multiple revisions. The sample prescriptions provided in this guide were designed to achieve a minimum weekly delivered Kt/V of 1.7 and to minimize patient burden. The sample prescriptions must not be considered medical advice and are not a substitute for clinical judgement.¹¹

• Minimal Delivered Weekly Clearance Goal: Kt/V ≥ 1.7¹¹
• Continuous Therapy: Fluid in peritoneal cavity seven days/week¹¹
• Ultrafiltration: ≥ 1.0 L/day. Adjustment of dialysis solutions including dextrose and icodextrin to meet the patient’s UF requirement is necessary. UF plays an important role in obtaining clearance. Increasing or decreasing UF also impacts clearance¹¹
• Residual Kidney Function: For patients with ≥ 2 mL/min of RKF, prescriptions are based on kidney urea clearance¹¹
• CAPD: 8-hour overnight exchange¹¹
• APD: 9-hour cycler time^{11, 12}
• A glucose-sparing strategy, using 1.5% and 2.5% dextrose solutions, was applied in modeling. Under these modeling assumptions, use of 4.25% was therefore precluded. However, 4.25% dextrose solutions can be used in situations of fluid overload¹¹

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