[Focusing on peritoneal dialysis adequacy].

Abstract:

:The optimal method to assess the adequacy of peritoneal dialysis therapies is controversial. Today, the adequacy must not be considered as a number or a concept assessed only by two parameters (total KT/V urea and total solute clearance) but defined by many more items. In the absence of data, based on theoretical considerations, the reanalysis of the CANUSA study showed that renal kidney function, rather than peritoneal clearance, was associated with improved survival. Residual renal function is considered as a major predictor factor of cardiovascular mortality. Results of this reanalysis were supported by the adequacy data in ADEMEX, EAPOS and ANZDATA studies. Therefore, clinical assessment plays a major role in PD adequacy. The management of fluid balance, the regular monitoring of malnutrition, the control of mineral metabolism and particularly the glucose load, considered as the "corner-stone" of the system, are the main points to be considered in the adequacy of PD patients. The essential goal is to minimize glucose load by glucose-sparing strategies in order to reduce the neoangiogenesis of the peritoneal membrane.

journal_name

Nephrol Ther

authors

Issad B,Durand PY,Siohan P,Goffin E,Cridlig J,Jean G,Ryckelynck JP,Commission de dialyse de la Société de néphrologie.,Arkouche W,Bourdenx JP,Cridlig J,Dallaporta B,Fessy H,Fischbach M,Giaime P,Goffin E,Issad B,Jean G,

doi

10.1016/j.nephro.2013.05.005

subject

Has Abstract

pub_date

2013-11-01 00:00:00

pages

416-25

issue

6

eissn

1769-7255

issn

1872-9177

pii

S1769-7255(13)00100-4

journal_volume

9

pub_type

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