BACKGROUND: It is widely assumed that obese patients are poorly suited for peritoneal dialysis (PD). Mathematical models predicting weight limits to achieve adequate solute clearance in anuric patients on continuous ambulatory PD therapy do not apply to the majority of obese patients on PD therapy. METHODS: To define the extent to which obesity or large body size interferes with successful PD, the feasibility of achieving adequate solute clearance, defined by the Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines, was studied. We reviewed prospectively recorded data for 25 obese patients (body mass index > or = 29) from a group of 58 prevalent PD patients treated in an inner-city ambulatory dialysis center. Adequacy of solute clearances was assessed by comparing weekly Kt/V and weekly creatinine clearance (WCC) with those recommended by the K/DOQI. Adequacy also was examined separately for large patients, defined as those with total-body water (TBW) by the Watson and Watson equation of 48 L or greater. Similar analyses were performed separately for 10 anuric obese patients. RESULTS: Eighty four percent and 88% of the 25 obese patients achieved K/DOQI targets for weekly Kt/V and WCC, respectively. Among the 10 anuric obese patients, 90% and 70% achieved these targets. Only 60% of those with TBW of 48 L or greater met the Kt/V target. CONCLUSION: PD remains a viable option for obese patients with end-stage renal disease. It is possible for the majority of obese patients on PD therapy to achieve solute clearances recommended by the K/DOQI. Copyright 2002 by the National Kidney Foundation, Inc.
BACKGROUND: It is widely assumed that obesepatients are poorly suited for peritoneal dialysis (PD). Mathematical models predicting weight limits to achieve adequate solute clearance in anuric patients on continuous ambulatory PD therapy do not apply to the majority of obesepatients on PD therapy. METHODS: To define the extent to which obesity or large body size interferes with successful PD, the feasibility of achieving adequate solute clearance, defined by the Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines, was studied. We reviewed prospectively recorded data for 25 obesepatients (body mass index > or = 29) from a group of 58 prevalent PD patients treated in an inner-city ambulatory dialysis center. Adequacy of solute clearances was assessed by comparing weekly Kt/V and weekly creatinine clearance (WCC) with those recommended by the K/DOQI. Adequacy also was examined separately for large patients, defined as those with total-body water (TBW) by the Watson and Watson equation of 48 L or greater. Similar analyses were performed separately for 10 anuric obesepatients. RESULTS: Eighty four percent and 88% of the 25 obesepatients achieved K/DOQI targets for weekly Kt/V and WCC, respectively. Among the 10 anuric obesepatients, 90% and 70% achieved these targets. Only 60% of those with TBW of 48 L or greater met the Kt/V target. CONCLUSION: PD remains a viable option for obesepatients with end-stage renal disease. It is possible for the majority of obesepatients on PD therapy to achieve solute clearances recommended by the K/DOQI. Copyright 2002 by the National Kidney Foundation, Inc.
Authors: Monika A Krezalek; Nicolas Bonamici; Kristine Kuchta; Brittany Lapin; JoAnn Carbray; Woody Denham; John Linn; Michael Ujiki; Stephen P Haggerty Journal: Surg Endosc Date: 2017-09-15 Impact factor: 4.584
Authors: Yoshitsugu Obi; Elani Streja; Rajnish Mehrotra; Matthew B Rivara; Connie M Rhee; Melissa Soohoo; Daniel L Gillen; Wei-Ling Lau; Csaba P Kovesdy; Kamyar Kalantar-Zadeh Journal: Am J Kidney Dis Date: 2017-12-07 Impact factor: 8.860