DIALYSIS DELIVERY IN CHILDREN ON NIGHTLY INTERMITTENT AND TIDAL PERITONEAL-DIALYSIS

To achieve more adequate dialysis in a shorter treatment time, seven c hildren, characterized as high/high average (H/HA, 5 patients) and low /low average (L/LA, 2 patients) transporters according to the peritone al equilibration test, were treated with tidal peritoneal dialysis (TP D) for 13.7+/-5.7 months, after being treated with nightly intermitten t peritoneal dialysis (NIPD) for a similar period. We determined the T PD prescription necessary to provide improved clearances compared with NIPD within the same or less treatment time. Dialysis flow rate was s ignificantly higher in TPD than NIPD, due to a reduction of dwell time and an increase in the number of exchanges. Peritoneal and total clea rances of urea and creatinine were higher, whereas serum creatinine an d urea nitrogen levels were lower and treatment duration shorter durin g TPD than NIPD, notwithstanding a decrease of residual renal function . Moreover, a mean time-averaged blood urea nitrogen level as low as 4 8.5 +/- 11.6 mg/dl was achieved during TPD. The improvement was more s ignificant in H/HA than in L/LA patients.