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- Title
Urea kinetic analysis of automated peritoneal dialysis allows calculation of a CAPD-equivalent Kt/V<sub>urea</sub>.
- Authors
Schurman, Scott J.; Shoemaker, Lawrence R.; Warady, Bradley A.
- Abstract
Urea kinetic analysis of automated peritoneal dialysis allows calculation of a CAPD-equivalent Kt/Vurea. Background. Based on evidence of increased mortality with decreasing urea clearance, the Dialysis Outcomes Quality Initiative (DOQI) recommended a weekly Kt/Vurea of 2.0 or higher for patients receiving continuous ambulatory peritoneal dialysis (CAPD). DOQI recommendations for automated peritoneal dialysis (APD) are based on efforts to determine the clearance providing urea mass removal equivalent to CAPD. We have adapted a variable volume direct quantitation urea kinetic model (UKM) in an effort to assess DOQI APD guidelines. Methods. The daily urea mass removed with a weekly Kt/Vurea of 2.0 was calculated using standardized CAPD patient profiles. Using this value and defining the pre-APD plasma urea nitrogen (PUN) as C0 and equal to the CAPD steady-state PUN, the UKM reiteratively calculated the urea clearance from an APD treatment that provided a urea mass removal equivalent to CAPD. A total weekly Kt/Vurea was calculated for various levels of continuous urea clearance (defined as Kprt/Vurea) and plotted against Kprt/Vurea (weekly). The impact of dialytic time (t), drain volume of the daytime dwell (δ), and ultrafiltration volume (φ) were assessed, and all profiles were performed with C0 equal to the corresponding blood urea nitrogen of 60, 70, and 80 mg/dL. Results. The relationship between requisite weekly Kt/Vurea and Kprt/Vurea (weekly) was linear. Weekly Kt/Vurea declined with increasing Kprt/Vurea, t, δ, and φ. The effect of φ on the weekly Kt/Vurea was independent of Kprt/Vurea, and the magnitude of the effect of t and δ on the weekly Kt/Vurea decreased with increasing continuous clearance. Weekly...
- Subjects
PERITONEAL dialysis; UREA; PERITONITIS; ULTRAFILTRATION
- Publication
Kidney International, 2000, Vol 58, Issue 3, p1318
- ISSN
0085-2538
- Publication type
Article
- DOI
10.1046/j.1523-1755.2000.00288.x