Intermittent peritoneal dialysis may provide borderline adequate dialysis in terms of clearance of small solutes. A number of disease processes could decrease clearances. Drug manipulations and other techniques to increase clearances primarily affect larger solutes. Since some small-molecular-weight solutes may be uremic toxins until proven otherwise, small solute clearance decreases during chronic intermittent peritoneal dialysis may require consideration of even more hours of intermittent peritoneal dialysis or initiation of CAPD.
