I am trying to achieve a target of 1.7 for a PD patient who has Crohn's disease. Patient was a slow transporter back in 2010 ( was transplanted) but now upon return to PD is a fast transporter. Patient can only fill with 2L max. Currently is on Cycler for 5 cycles over nine hours – KT/V is 1.45. Patient does make urine last collection approximately 750ml and is on Lasix. I am thinking of keeping APD regimen the same but adding icodextrin for day dwell. Thank you.

Questions About PD

Sue, Nurse from Dialysis Clinic asked
I am trying to achieve a target of 1.7 for a PD patient who has Crohn's disease. Patient was a slow transporter back in 2010 ( was transplanted) but now upon return to PD is a fast transporter. Patient can only fill with 2L max. Currently is on Cycler for 5 cycles over nine hours – KT/V is 1.45. Patient does make urine last collection approximately 750ml and is on Lasix. I am thinking of keeping APD regimen the same but adding icodextrin for day dwell. Thank you.

1 answer

Doctor (Canada) 6 days ago

A day dwell is definitely the best option to enhance clearance in this instance. If the patient is a rapid transporter, Icodextrin would be a good choice to avoid fluid absorption during the long dwell (which would be likely with a glucose-based solution). A Kt/V target of 1.7 should be considered a rough guideline – for example, if the patient is clinically well with a Kt/V of 1.6, there would be no need to increase clearance further.

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