Significance of peritoneal dialysis volume calculation based on the status of residual renal function

Objective:The correlation among the peritoneal dialysate volume(PDV) applied to peritoneal dialysis(PD) patients under different dialysis efficiencies,residual renal function(RRF) and body surface area(BSA) was retrospectively investigated,thus having summarized a method for calculating PDV in conformity with the physiological and disease characteristics of Chinese patients. Methodology:Measurement has been made for 1 650 times to 414 patients who have taken medium-position dialysis for 14.8 months(6-161 months) and been divided into three groups of adequacy,critical and inadequacy according to the 2006 NKF-K/DOQI standard.The changes of urea Kt/V,creatinine clearance rate(Ccr),protein expression rate(nPNA),plasma albumin(Alb),residual glomerular filtration rate(rGFR),PDV and PDV of unit BSA(PDV/BSA) of each group patients and the relationship among such factors have been studied. Results:With measurement for 1 650 times,the majority of patients have been dialyzed adequately,while only 391 cases have been dialyzed inadequately,covering 23.7%.As indicated by the analysis,there were significant differences(P0.01 and P0.01) in urine volume(UV) and rGFR,as well as in PDV and PDV/BSA for such three group.According to the research,it has also been observed that rGFR in the dequate dialysis cases was remarkably higher than that in other groups(P0.01),while PDV/BSA there of was obviously less than that in other groups(P0.01).As indicated by the observation of rGFR in different groups,PDV required for different RRF was significantly different(F=189.3,P0.01).The correlation between rGFR and PV/BSA was further discussed,with correlation coefficient between them capable of being formulated as follows: PV/BSA=4 277.0-123.7×rGFR(r=-0.58,P0.01).Therefore,the formula for calculating individual PDV of PD patients was got as follows: PDV(L/d)=(4.4-0.15×rGFR) ×BSA. Conclusion:PDV for all PD patients shoud be calculated according to RRF and BSA status.Such individual dialysis scheme is capable of not only exerting the advantages of RRF in PD to the maximum,but also saving dialysate dosage and reducing economic expenses of the patients.