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Should the Doqi Adequacy Guidelines be used to Standardize the Peritoneal Dialysis Dose in Children?

T first report of maintenance hemodialysis (HD)—as a once-weekly treatment regimen complicated by diffuse metastatic calcification and debilitating neuropathy—appeared in 1960 (1). Initial reports of maintenance peritoneal dialysis (PD) typically involved only 2 – 3 treatments weekly, with continuous ambulatory peritoneal dialysis (CAPD) first being described in 1976 (2). Since these early reports, the definition of dialysis adequacy has steadily evolved, driven in large part by prospective studies of dialysis morbidity and mortality outcomes in adult patients (3,4) and culminating in the attempts by the Dialysis Outcomes Quality Initiative (DOQI) to define minimum dialysis standards for adults and children (5,6).