Single-pass continuous flow peritoneal dialysis using two catheters

With a renewed interest in continuous flow peritoneal dialysis (CFPD), our standard practice of implanting a second catheter in those patients facing access failure provided us the opportunity to perform acute studies on CFPD in these patients, since it temporarily provided us with two catheters. Four patients were studied, with a total of five studies performed. A standard protocol was followed utilizing 1.5% dextrose solution, a 2 L fill, an inflow rate of 200 ml/min with a proportionate outflow for a 4-hour session. A full drain was performed at the end of the study. Our results provided us with a mean effective peritoneal clearance for urea (K-peU) and creatinine (K-peCr) of 40 ml/min and 28 ml/min, respectively, and a mean ultrafiltration rate (Q(f)) of 13.4 ml/min. Our average mass transfer coefficient (MTC) for urea was 40 ml/min, consistent with kinetic modeling and historical data. The K-pe, MTC, and Q(f) achieved are significantly higher than other investigators, which could possibly be explained by those obtained by two separate catheters resulting in adequate mixing of the dialysate. These clinical results provide a solid foundation for the future development of this PD modality.