Switching From PD to the Nighttime Cycler


Hi! Have not been on the board in awhile but have a question relating to my dad trying the nighttime cycler with the plan that he switches to that type of treatment from his 4 PD treatments daily. His nurse provided him with a figure that determined that PD was not working well enough for him–my dad isn’t sure what that figure represents. He was told that his figure is 1.5 and that the minimum normal for this particular figure is 1.7 or greater. Do you know what that figure might represent?

He will be spending Friday (tomorrow) in clinic being dialyzed to determine if this treatment will work for him and to train. Because he isn’t able to remove enough fluid through PD, his nurse gave him the choice of using higher volumes of dialysate for each treatment (2500 mL instead of 2000) or doing 5 treatments a day instead of 4 or trying the cycler.

Thanks for your help!


Hi Eileen,

That number would be his weekly Kt/V, which is a measure of dialysis “adequacy” (basically the LEAST dialysis someone is supposed to get). Weekly Kt/V for PD is supposed to be 1.7 per week, or more.

Kt/V is based on the amount of urea the PD removes. Urea (a waste that forms when protein is broken down) is a very small molecule, and not toxic. But it is cheap and easy to measure, and VERY easy to remove. So, if your dad’s PD isn’t removing enough urea, it’s a sure bet that it’s not removing enough of the other toxins that really do matter.

Getting more PD is either a matter of doing more exchanges each day, or using more fluid. Some tweaking can also occur in the dwell time (length of time the PD fluid stays in the belly). You might find some of our PD articles helpful:
– The Peritoneal Equilibrium Test (PET): http://www.homedialysis.org/resources/tom/200801/
– Tailoring Automated PD (APD) to Your Life: http://www.homedialysis.org/resources/tom/200805/

Thanks, Dori. I knew you would know! Have a great night.