Figure 414

Using transport type to select a peritoneal dialysis regimen. Because clearance rates continue to increase with time, patients with low transport rates are treated with long dwell exchanges, ie, continuous cyclic peritoneal dialysis (CCPD). Owing to the low rate of increase in the dialysate to plasma ratio (D/P), the clearance rate per unit of time is augmented relatively little by rapid exchange techniques such as nightly intermittent peritoneal dialysis (NIPD). On the contrary, the clearance per exchange rate over long dwell exchanges would be less in patients with high transport rates. During the short dwell time, patients with high transport rates capture maximum ultrafiltration and small solutes are completely equilibrated. Therefore, these patients are best treated with techniques using short dwell exchanges, ie, NIPD or daytime ambulatory peritoneal dialysis (DAPD). Patients with average transport rates can be effectively treated with either short or long dwell exchange techniques. CAPD—continuous ambulatory peritoneal dialysis.

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