Individualized dialysis for CAPD patients: a review of the experience at the University of Missouri.

The efficiency of continuous ambulatory peritoneal dialysis (CAPD) depends on dialysate flow rate or daily drainage volume. With an increase in the volume of an exchange, the number of exchanges can be diminished while retaining the efficiency of dialysis. A great variation among patients in metabolic generation rate, residual renal function, intraperitoneal volume tolerance, and peritoneal mass transfer necessitates an individualization of dialysis schedule. Changes in serum urea and creatinine concentrations combined with clinical assessment are usually sufficient guides for the prescription of dialysate flow rate to achieve adequate dialysis. Only if the reason of underdialysis is not apparent, the evaluation of peritoneal dialysis kinetics may be needed for optimized treatment.