EVALUATION OF CURRENT CLINICAL-PRACTICE IN CAPD FOR FUTURE IMPROVEMENT OF TREATMENT PRESCRIPTION

Criteria for equivalent doses of dialysis in CAPD and hemodialysis (HD ) were developed by urea kinetic analysis of the two therapies. The an alysis indicated that weekly combined peritoneal plus renal urea clear ance (KprT) divided by body urea space (V) or KprT/V of 2.0 is approxi mately equivalent to Kt/V of 1.0 in HD. A clinical evaluation of CAPD in current clinical practice was undertaken in 140 patients in 15 diff erent U.S. dialysis units. The results indicate nearly all patients ar e treated with four 2 liter exchanges per day which results in mean Kp rT/V of 1.9 but a range of 0.7 to 3.5. The corresponding equivalent HD Kt/V values are 1.7 mean and range from 0.3 to 3.5. We conclude there is need for a study of clinical outcome in CAPD with KprT/V prospecti vely randomized over the range found in current clinical practice.