While this is a PD question and is best dierected to our PD advisor, the slow reduction in and ultimate failure [insufficiency might be a beter word] of UF is the main technique-limiting factor in longer-term PD that ultimately leads to the failure of PD as an effective therapy.
Slowly, over time - luckily measured in years - there is a subtle change in the single cell layer of ‘mesothelial cells’ - the cells that line the peritoneal membrane - as they thicken and heap-up in a cobblestone pattern under the effect of AGE (Advanced Glycation End-products).
This ‘AGE’-ing process occurs as a result of the glucose that is used in PD fluid as a water-drawer (an osmotic agent), and it is sadly largely unpreventable, though some of the more physiological PD fluids (eg: Physioneal) or fluids like Icodextrin can help slow the process of UF failure.
UF failure is the commonest reason why PD, as a therapy, ultimately fails. We have, in the past, been too slow to recognise ‘membrane decline’. More recently, we have recognised our once-slow reaction time to UF failure and, instead of flogging PD to the point where symptoms of under-dialysis, malnutrion, a falling albumin, and general failure-to-thrive emerge, we have encouraged proactive steps to train home-adjusted PD patients into home HD when the signs of UF failure begin to be clear ... thus transitioning from home PD to home HD as seamlessly as possible and avoiding centr-based care.
In the short term, increasing the concentration of your PD fluid will help increase your UF, but increasing the sugar content (concentration) also hastens membrane deterioration = a Catch-22.
You should discuss this with your home team, and formulate a step-wise plan to aid transition. They will help explain what I have outlined here more clearly. But ... to be honest ... UF failure is usually ‘the writing on the wall’ for the ultimate failure of PD as an effective dialysis modality ... and early preparation for a replacement option - and we woukd suggest, here, home HD - is a crucial step that ought not be delayed.
This includes (especially) the early placement of an AVF so it is reafy, when needed, for (hopefully) home HD training ... as I am afraid it will be.