Can the DOQI guidelines be met by peritoneal dialysis alone in pediatric patients?

DOQI guidelines recommend minimal standards for automated peritoneal dialys is (APD), with a weekly Kt/V of 2.1 and creatinine clearance (Cc,) of 63 l/ 1.73 m(2), The purpose of this study was to assess if the DOQI guidelines c ould be met by dialysis alone in children on PD, Dialysis clearance studies were retrospectively analyzed in 20 pediatric patients on APD, all with a dwell volume of at least 1,000 ml/m(2). Mean dialytic Kt/V was 2.0; only 45 % had a Kt/V above the recommended 2.1. Mean dialytic C-Cr was 33.5 l/week per 1.73 m(2); only 10% achieved a C-Cr above the recommended 63 l/week per 1.73 m(2). Despite the significant correlation between total therapy volum e (TTV) and both Kt/V and C-Cr, only 2 of 10 patients with a TTV over 10 l/ m(2) per day reached the target C-Cr. All patients had currently recommende d dwell volumes, therapy times, and nocturnal cycles, but DOQI guidelines w ere difficult to achieve with dialysis alone. Strict adherence to DOQI guid elines in anephric pediatric PD patients may result in changing dialysis mo dality. However, without evidence of a correlation between delivered dose o f dialysis and improved outcome, adequate dialysis should not be assessed b y only measuring Kt/V and C-Cr.