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Adequacy of peritoneal dialysis

  • J. M. Burkart

Abstract

As a renal replacement therapy, dialysis, at best, only approximates normal renal function (Table 1). Despite these deficiencies, however, dialysis has extended the lives of end-stage renal disease (ESRD) patients, some for over 20 years [1]. Although many patients do very well on dialysis, data compiled by the Health Care Financing Administration (HCFA) and analysed by the United States Renal Disease System (USRDS) have shown that the gross mortality rate for the United States ESRD population (predominantly haemodialysis (HD) patients) in 1990 was 24% [2]. The extent to which uraemia in the form of underdialysis contributed to this overall mortality rate in ESRD patients is unknown. Some have suggested that inadequacies in the prescribed dose of dialysis were contributing to these high mortality rates [3, 4]. As a result, more attention has been paid to patient outcome and to optimizing total solute clearance. The mean Kt/V for subpopulations of HD patients has increased from 1.0/Rx in patients starting dialysis during 1986-87 to 1.22/Rx in a random sample of prevalent HD patients in December 1993 [5]. Associated with this change there has been a gradual increase in the adjusted 1-, 2- and 5-year patient survival percentages for patients starting dialysis over the years 1979–73.

Keywords

Peritoneal Dialysis Continuous Ambulatory Peritoneal Dialysis Peritoneal Dialysis Patient Residual Renal Function Dietary Protein Intake 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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© Springer Science+Business Media Dordrecht 2000

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  • J. M. Burkart

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