PD Therapy. Determining what % of dialysate to use


I am curious hear what rules people are using to determine which dialysate to use in their PD therepy.


PD dialysate contains dextrose in concentrations of 1.5%, 2.5%, and 4.25%. Higher percentages of dextrose remove more fluid, but can scar the peritoneal membrane so it doesn’t transport wastes. This scarring could make PD unable to provide adequate dialysis requiring a switch to HD. In my experience working as a social worker in dialysis, I often heard home training nurses encouraging patients to limit the use of 4.25% solution and only use it for fluid overload. If you’re watching your salt and fluids, you should not have fluid overload. Your doctor should prescribe your treatment and your home training nurse should be able to advise you how to choose which PD solution to use.

Kidney School has a module on dialysis adequacy that discusses PD as well as HD.