title: Optimal number of dialysate exchanges in automated peritoneal dialysis.
abstract: Means of enhancing the efficiency of dialysis in automated peritoneal dialysis (APD) should be sought. Optimum cycles of exchange in APD were studied using a simple urea kinetic model. The amount of dialysis urea was expressed as the total amount removed divided by the initial plasma level (M/CB). A highly significant correlation between calculated and measured M/CB levels (r = 0.902, p < 0.001) was observed. The kinetic study indicated an increase in cycles to greatly enhance M/CB for high membrane transporter patients, in contrast to low transporters. Maximum M/CB for 8 hours was obtained by 5 cycles at D/P (120 minutes) of 0.4, 6 cycles at D/P of 0.7, and 9 at D/P of 0.9 when 2 L were infused. An increase in infusion volume from 2--3 L augmented M/CB by only 7% at D/P of 0.4, while M/CB was augmented by 14% at D/P of 0.9. The optimum number of cycles may thus be concluded to depend on peritoneal membrane permeability. A high transporter patient requires frequent exchanges for increasing dialysis efficiency, whereas a low transporter patient does not.
authors.affiliation: Kidney Center, Kitasato University Hospital, Kanagawa, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kumano
authors.forename: A
authors.initials: A
authors.lastname: Yamashita
authors.forename: T
authors.initials: T
authors.lastname: Sakai
mesh_terms: D006801:Humans; D008954:Models, Biological; D010530:Peritoneal Dialysis / Q000379:methods; D014508:Urea / Q000378:metabolism
chemical_list: D014508:Urea