The 2006 K/DOQI guidelines for peritoneal dialysis adequacy are not adequate.
The 2006 National Kidney Foundation K/DOQI guidelines have lowered the peritoneal dialysis adequacy standard of Kt/V(urea) from 2.1 to 1.7 in anuric patients, largely based on the patient survival results of 2 clinical trials in Mexico and Hong Kong. It is our contention that the guidelines may be misleading since they have chosen to ignore the bias in these trials and have ignored the adverse outcomes in control groups in the trials on which the guidelines are based, as well as the body size of the subjects in these trials. Body size has changed in the US and Canada over the last few decades and there are similar changes worldwide. We suggest that the minimum targets for peritoneal dialysis be reinstituted at the previous standard Kt/V(urea) of 2.0.
Winchester
James F
JF
Division of Nephrology and Hypertension, Beth Israel Medical Center, 350 East 17th Street, New York, NY 10003, USA. jwinches@bethisraelny.org
Harbord
Nikolas
N
Audia
Patrick
P
Dubrow
Alan
A
Gruber
Stephen
S
Feinfeld
Donald
D
Amerling
Richard
R
D015992:Body Mass Index; D002170:Canada; D006801:Humans; D008657:Metabolic Clearance Rate; D010530:Peritoneal Dialysis / Q000379:methods / Q000592:standards*; D017410:Practice Guidelines as Topic / Q000592:standards; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D014481:United States; D014508:Urea / Q000378:metabolism
D014508:Urea