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lüll Urea is the best molecule to target adequacy of peritoneal dialysis Gotch FAPerit Dial Int 2000[]; 20 Suppl 2 (ä): S58-64For hemodialysis, a large base of data shows the validity of modelling the dialysis dose and reliably estimating protein intake from equilibrated Kt/V urea (eKt/VU), the total dialyzer urea clearance provided during each treatment divided by the urea distribution volume. An eKt/VU of 1.05 thrice weekly is judged adequate, but is still under study. In continuous ambulatory peritoneal dialysis (CAPD), two dosage criteria are widely recognized: continuous ("standard") Kt/VU (stdKt/VU = 2.0 weekly), and total creatinine (Cr) clearance normalized to body surface area (KCrT = 70 L/week/1.73 m2). The CANUSA study concluded that a stdKt/VU of 2.1 and a KCrT of 70 L/week/1.73 m2 gave equivalent clinical outcomes. The Dialysis Outcomes Quality Initiative (DOQI) recommends values of 2.0 and 60 L/week/1.73 m2 respectively. An analysis of these two parameters for males and females over a wide range of body surface areas (BSAs) was done and the analysis showed: (1) The U and Cr dose criteria are incommensurable--that is, they can virtually never be achieved simultaneously in anephric patients. (2) The Cr criterion varies widely with the sex of the patient and with the BSA-dependent variation in stdKt/VU over a range of 2.1 to 3.0. (3) The U criterion always produces a KCrT < 60 L/week/1.73 m2 in females and 60-70 L/week/1.73 m2 in males. With respect to U and Cr, the CANUSA results were concluded to be valid in patients with substantial residual renal function, but probably not applicable to anephric patients where the doses are clearly incommensurable.|Creatinine/pharmacokinetics[MESH]|Female[MESH]|Humans[MESH]|Kinetics[MESH]|Male[MESH]|Metabolic Clearance Rate[MESH]|Peritoneal Dialysis/methods/*standards[MESH]|Urea/*pharmacokinetics[MESH]|Uremia/prevention & control[MESH] |