How to Increase Adequacy of Peritoneal Dialysis in Children?

Abstract

Since children on dialysis are treated most often with nightly intermittent peritoneal dialysis, adequacy of dialysis is determined by the number and duration of cycles, the volume of the dialysis fluid applied, and the choice of dialysis solution. The number and duration of cycles are dependent on the maximal acceptable duration of night rest and the permeability properties of the peritoneal membrane. The latter can be established by performance of a peritoneal equilibration test. The volume used should be about 1200 mL/m² body surface area, and intraperitoneal pressure should be between 5 and 15 cm H₂O. The dialysis solution administered should have a glucose concentration as low as possible, and an icodextrin daytime dwell may be considered.