Bedeutung von PET und Kt/V für die Peritonealdialyse

PET should be monitored 4 weeks after the start of peritoneal dialysis (PD) and then yearly, and Kt/V every 3 months. PET makes it possible to determine different velocities of glucose absorption (from the dialysate) and of the transport of such low-molecular-weight substances as creatinine and urea (from blood to dialysate), and in particular to calculate the prognosis of the long-term ultrafiltration capacity of the peritoneum in each PD patient. Kt/V is a measure of the urea clearance both of the peritoneum and of the actual kidneys; it seems that preservation of any residual renal function has a more significant positive influence on patient survival and on the technical course than does an increase of the dialysis dose. It is accepted that PD is working efficiently when Kt/V is over 1.7. Besides PET and Kt/V clinical (well-being, eating behaviour, whether body weight is steady, functional capacity) and other (blood pressure, neurological status, degree of anaemia, calcium/phosphate ratio) criteria are also important in the evaluation of whether PD treatment is adequate.