Adequacy of peritoneal dialysis: a quality improvement project of The Renal Network, Inc (Illinois, Indiana, Kentucky, and Ohio).

The Renal Network, Inc, (end-stage renal disease [ESRD] Networks 9 and 10) from the states of Illinois, Indiana, Kentucky, and Ohio includes approximately 4,250 peritoneal dialysis patients. To better assess the state of peritoneal dialysis in Networks 9 and 10, we undertook a peritoneal dialysis prescription adequacy quality improvement project. Adequacy and facility practice information were obtained from a 100% sample of peritoneal dialysis patients in the Networks. The mean total Kt/V urea for those facilities with a written policy for adequacy measurement was 2.18 +/- 0.66 versus a mean of 2.13 +/- 0.70 for those facilities without a written policy (P = not significant [NS]). The mean total Kt/V urea for those facilities with a written procedure was 2.17 +/- 0.66 versus a mean of 2.12 +/- 0.70 for those facilities without a written procedure (P = NS). There was a significant positive relationship between the observed total Kt/V urea and the frequency of measurement (P <.001). No relationship existed between the value of the D/P creatinine ratio and the weekly dialysis Kt/V. This study supports the recommendation of frequent measurement of peritoneal dialysis adequacy.