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By Mayo Clinic staffMany factors affect how well peritoneal dialysis works in removing wastes and extra fluid from your blood. These factors include:
- Your size
- How quickly your peritoneum filters waste (peritoneal transport rate)
- How much dialysis solution you use (fill volume)
- The number of daily exchanges
- Length of dwell times
- The concentration of sugar (dextrose) in the dialysis solution
Your health care team will perform several tests to check if your dialysis is removing enough waste products. During the first weeks of dialysis, these tests help determine whether you're receiving an adequate amount, or dose, of dialysis.
- Peritoneal equilibration test (PET). This test measures how much sugar has been absorbed from a bag of used dialysis solution. It also measures how much of two waste products — urea and creatinine — are in the solution after a four-hour exchange.
- Clearance test. Samples of used dialysis solution and venous blood are collected to compare the amount of urea in the used solution with the amount in the blood. If you still produce urine, your doctor may take a urine sample at the same time to measure its urea concentration.
If the test results show that your dialysis schedule is not removing enough wastes, your doctor may change your dialysis routine. This might involve changing the number of exchanges, increasing the amount of solution you use for each exchange or using a dialysis solution with a higher concentration of dextrose.
You can improve your dialysis results and your overall health by eating the right foods, including foods low in sodium and phosphorus. A dietitian can help you develop an individualized meal plan based on your weight, your personal preferences, your remaining kidney function and other medical conditions, such as diabetes or high blood pressure.
Taking your medications as prescribed also is important for getting the best possible results. While you're receiving peritoneal dialysis, you'll likely need various medications to control your blood pressure, stimulate production of red blood cells, control the levels of certain nutrients in your blood and prevent the buildup of phosphorus in your blood.
- Peritoneal dialysis: What you need to know. National Kidney Foundation. http://kidney.niddk.nih.gov/kudiseases/pubs/peritoneal/. Accessed April 16, 2013.
- Papadakis MA, et al. Current Medical Diagnosis & Treatment 2013. 52nd ed. New York, N.Y.: The McGraw-Hill Companies; 2013. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=1. Accessed April 16, 2013.
- Chaudhary K, et al. Peritoneal dialysis first: Rationale. Clinical Journal of the American Society of Nephrology. 2011;6:447.
- Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed April 16, 2013.
- Post TW, et al. Overview of the management of chronic kidney disease in adults. http://www.uptodate.com/home. Accessed April 16, 2013.
- Lerma EV, et al. Current Diagnosis & Treatment: Nephrology & Hypertension. New York, N.Y.: The McGraw-Hill Companies; 2009. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=628. Accessed April 16, 2013.
- Peritoneal dialysis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/genitourinary_disorders/renal_replacement_therapy/peritoneal_dialysis.html#v1054643. Accessed April 18, 2013.
- Peritoneal dialysis: What you need to know. National Kidney Foundation. http://www.kidney.org/atoz/pdf/peritonealdialysis.pdf. Accessed April 16, 2013.
- Anderson CF (expert opinion). Mayo Clinic, Rochester, Minn. April 20, 2013.
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