Peritoneal dialysis adequacy and risk of death

The debate on the relationship between small solute clearance and patient o utcome on peritoneal dialysis has intensified in the past year with the pub lication or presentation of a number of important new studies. Previous stu dies had found a correlation between clearances and subsequent patient surv ival. However, this effect was all accounted for by residual renal clearanc e. The failure to detect an independent effect of peritoneal clearance on o utcomes had been attributed to a lack of well-done studies with sufficient variation in peritoneal clearance to detect such an effect. New prospective and randomized studies suggest, however, that the relationship between per itoneal clearance and outcome is weak or absent within the usual dose range s delivered in clinical practice. Existing clearance targets may need to be reviewed. Curr Opin Nephrol Hypertens 10:749-754. (C) 2001 Lippincott Will iams & Wilkins.