How are you handling patients with high residual renal function? Example: Kt/V 4.5 with the PD contribution of 1.53. Another patient with a Kt/V of 4.78 with the PD contribution of 1.21. Would you decrease the PD exchange/exchange volume?

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Carl D, Doctor/MD from Texas asked
How are you handling patients with high residual renal function? Example: Kt/V 4.5 with the PD contribution of 1.53. Another patient with a Kt/V of 4.78 with the PD contribution of 1.21. Would you decrease the PD exchange/exchange volume?

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MD from South America March 26, 2020

If residual renal function is high you may consider incremental PD, with a schedule (number of exchanges and volume) according with peritoneal membrane characteristics

#1
Doctor (Canada) 4 days ago

These patients could do incremental PD. This can be achieved in several different ways depending on whether the patient is on CAPD or APD. There are several papers that discuss incremental PD, including an excellent recent review in PDI:
Incremental peritoneal dialysis. Blake PG, Dong J, Davies SJ. Perit Dial Int. 2020 Jan 17
 

#2

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