Questions About PD
We thank you for your question. To calculate the dialysate Kt/V when using PD 5 days a week, you should change the calculation to multiply by 5 rather than 7. This will then provide you with the total weekly dialysate Kt/V. If your program/app does not allow you to do this and only calculates it for a 7 day/week regime, then you simply multiply the calculated Kt/V by 5/7 (i.e. divide by 7 then multiply by 5) for this particular patient. You should calculate the renal as usual for 7 days.
We would also strongly suggest that you do pay attention to the trend over time of your patient’s residual renal function (urine output), and, if that is observed to be decreasing, you should consider increasing the patient’s PD prescription. Possibly though, most important, is: How does your patient feel? If your patient has increasing symptoms of uremia (e.g. fatigue, lack of appetite), we would recommend increasing the patient’s PD prescription, providing that this new prescription fits in with the goals and lifestyle of the patient (1).
1.Brown EA, Blake PG, Boudville N, Davies S, de Arteaga J, Dong J, Finkelstein F, Foo M, Hurst H, Johnson DW, Johnson M. International Society for Peritoneal Dialysis practice recommendations: Prescribing high-quality goal-directed peritoneal dialysis. Peritoneal Dialysis International. 2020 May;40(3):244-53. Available at: https://journals.sagepub.com/doi/pdf/10.1177/0896860819895364