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COMPARISON OF THE MULTIPLE-ALIQUOT AND BATCH METHODS OF MONITORING PERITONEAL DIALYSIS ADEQUACY IN PATIENTS

♦ Background: Effluent fluid is analyzed to determine Kt/V urea and creatinine clearance as measures of adequacy of peritoneal dialysis. To avoid the physical mixing of fluids and to minimize handling of full effluent bags, a multiple-aliquot method of sampling was developed and compared to the traditional batch method. ♦ Methods: The batch method and the multiple-aliquot method were performed for 31 consecutive patients. Pooled fluid urea and creatinine measurements were determined for each method. PD Adequest 2.0 (Baxter Healthcare, Deerfield, IL, USA) was used to derive calculated peritoneal dialysis parameters. ♦ Results: Urea dialysate levels, calculated weekly urea clearances, protein catabolic rate, and Kt/V were not statistically different (p > 0.05) between the 2 methods. Dialysate creatinine and creatinine clearance with the 2 methods were statistically distinct but the differences were not clinically important. The processing time per set of patient effluent bags was reduced from 45 to 18 minutes, handling of the bags was minimized, and error associated with inadequate mixing of pooled fluids was avoided. ♦ Conclusion: The multiple-aliquot method generates accurate and timely results to assess peritoneal dialysis prescription adequacy while reducing staff effort.