title: Dialysis adequacy of Asian patients receiving small volume continuous ambulatory peritoneal dialysis.
abstract: The usage of three x 2 liter daily exchanges is adopted as the standard CAPD regime in Hong Kong over the last 10 years due to budgetary constraint. This dialysis prescription is considered suboptimal in Western standard. However, the necessity of maintaining Kt/V > 1.7 for CAPD dialysis adequacy is not unanimously agreed. We performed a cross-sectional study of 117 patients on CAPD. Seventy-eight percent of our patients had 3 x 2 liter daily exchange while the rest had 4 daily exchanges. Fifteen percent of patients were diabetic. Patients with Kt/V < 1.7 were similar to those with Kt/V > 1.7 in age, duration of CAPD, BUN, plasma creatinine, albumin, peritonitis rate, and incidence of hypertension. Patients with Kt/V > or = 1.7 had higher hemoglobin, higher nPCR, more residual renal function; and more of them received 4 daily exchanges. Their peritoneal permeability did not differ. Their employment and rehabilitation status was also similar. Our 5-year survival was 79% despite a lower Kt/V. Notably, the protein catabolic rate of our patients was higher than that in Western patients. This is likely due to dietary difference. Our study suggests small-volume dialysis may be acceptable in Asian population with smaller body size given the financial constraint.
authors.affiliation: Department of Medicine, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, China.
authors.forename: C C
authors.initials: CC
authors.lastname: Szeto
authors.forename: K N
authors.initials: KN
authors.lastname: Lai
authors.forename: A W
authors.initials: AW
authors.lastname: Yu
authors.forename: C B
authors.initials: CB
authors.lastname: Leung
authors.forename: K K
authors.initials: KK
authors.lastname: Ho
authors.forename: T W
authors.initials: TW
authors.lastname: Mak
authors.forename: P K
authors.initials: PK
authors.lastname: Li
authors.forename: C W
authors.initials: CW
authors.lastname: Lam
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D001806:Blood Urea Nitrogen; D002681:China; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D004032:Diet; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000191:economics / Q000379:methods*; D012709:Serum Albumin / Q000032:analysis; D015996:Survival Rate; D014508:Urea / Q000097:blood
chemical_list: D006454:Hemoglobins; D012709:Serum Albumin; D014508:Urea; D003404:Creatinine