Abstract: FR-PO1104
A Practical Formula to Predict Dialysate Volume for Achieving Small-Solute Clearance Targets in Peritoneal Dialysis
Session Information
- Home Dialysis: Modalities, Barriers, Utilization, and Clinical Outcomes
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Sritippayawan, Suchai, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
- Srithongkul, Thatsaphan, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
- Raksasuk, Sukit, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
Background
Peritoneal dialysis (PD) prescriptions are frequently empirical and may not adequately account for body size and residual urine volume. We developed simplified equations to estimate the daily total dialysate volume (dTV) required to achieve small-solute clearance targets in continuous ambulatory PD (CAPD) and nocturnal intermittent PD (NIPD) and validated them in a new PD cohort.
Methods
We analyzed adult PD patients who underwent standard PD adequacy and peritoneal equilibration testing. The derivation cohort included 246 CAPD and 100 NIPD patients. Mean D/Purea, D/P creatinine (cr), U/Purea, cr urine volume (UV), furosemide dose, and total body water (TBW) were used to derive simplified dTV equations for achieving a weekly total Kt/V urea ≥ 1.7. A subsequent cohort evaluated formula-guided prescription in 31 PD patients (15 CAPDs and 16 NIPDs). The primary validation outcome was achievement of Kt/V ≥ 1.7 after one month. Agreement between formula-predicted and actual drained volume was assessed using correlation and Bland-Altman analysis.
Results
In CAPD, mean D/Purea and D/Pcr were 0.94±0.10 and 0.73±0.10, respectively. The simplified dTV equation for achieving Kt/V ≥ 1.7 was 0.26×TBW−4×UV in patients with furosemide < 250 mg/day and 0.26×TBW−3×UV in patients with > 250 mg/day. In NIPD, mean D/Purea was lower, requiring greater dTV = 0.36×TBW−6×UV in non-users of furosemide and 0.36×TBW−5×UV in furosemide users. NIPD required approximately 40% greater dTV than CAPD to achieve comparable small-solute clearance targets. In the validation cohort, 11 of 15 CAPD patients (73.3%) achieved Kt/V ≥1.7 after formula-guided prescription, with minimal mean bias between predicted and actual drained volume. In NIPD, 8 of 16 patients (50.0%) achieved Kt/V ≥ 1.7. Among NIPD patients with Kt/V <1.7, actual drained volume frequently exceeded predicted volume.
Conclusion
A simplified dialysate volume prediction formula based on total body water, body surface area, urine volume, and furosemide use provides a practical method for estimating PD prescriptions required to achieve prespecified small-solute clearance targets in more than half of patients and may support individualized bedside PD prescription. In NIPD patients, additional factors, including dwell time and peritoneal transport characteristics, may need to be incorporated into the predictive formula.
Funding
- Government Support – Non-U.S.