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Background

The International Society for Peritoneal Dialysis (ISPD) last published guidelines on prescribing peritoneal dialysis (PD) in 2006. 1 These focused primarily on targets for small solute removal (Kt/V urea and creatinine clearance) and ultrafiltration. Even though the recommendations in that guideline started with the statement,‘Adequacy of dialysis should be interpreted clinically rather than by targeting only solute and fluid removal’, the guideline has often been interpreted as stating that there must be a minimum small solute removal target. Indeed, in some healthcare settings, delivery of PD has focused on achieving the small solute targets suggested in the 2006 guideline without taking into consideration the impact of increasing dialysis exchanges or hours on a cycling machine on a person’s quality of life.