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. Dialysis adequacy has a major impact on the outcome of  continuous ambulatory peritoneal dialysis (CAPD) patients. However, most  studies on peritoneal dialysis adequacy have focused on patients with  significant residual renal function. The present study examined the effect of  dialysis adequacy on anuric CAPD patients. A single-center prospective  observational study on 140 anuric CAPD patients was performed. These patients  were followed for 22.0 ± 11.9 mo. Dialysis adequacy and nutritional  indices, including Kt/V, creatinine clearance (CCr), protein equivalent  nitrogen appearance, percentage of lean body mass, and serum albumin level  were monitored. Clinical outcomes included actuarial patient survival,  technique survival, and duration of hospitalization. In the study population,  64 were male, 36 (25.7%) were diabetic, and 59 (42.1%) were treated with 6 L  exchanges per day. The body weight was 59.2 ± 10.2 kg. Average Kt/V was  1.72 ± 0.31, and CCr was 43.7 ± 11.5 L/wk per 1.73m 2 .  Two-yr patient survival was 68.8%, and technique survival was 61.4%.  Multivariate analysis showed that DM, duration of dialysis before enrollment,  serum albumin, and index of dialysis adequacy (Kt/V or CCr) were independent  factors of both patient survival and technique survival. It was estimated that  for two patients who differed only in weekly Kt/V, a 0.1 higher value was  associated with a 6% decrease in the RR of death ( P  &lt; 0.05; 95%  confidence interval, 0.92 to 0.99). Serum albumin and CCr were the only  independent factors that predicted hospitalization. It was found that even  when there is no residual renal function, higher dialysis dosage is associated  with better actuarial patient survival, better technique survival, and shorter  hospitalization. Dialysis adequacy has a significant impact on the clinical  outcome of CAPD patients, and the beneficial effect is preserved in anuric  patients as well as in an ethnic group that has a low overall mortality.

Impact of Dialysis Adequacy on the Mortality and Morbidity of Anuric Chinese Patients Receiving Continuous Ambulatory Peritoneal Dialysis