In peritoneal dialysis, adequacy is assessed by which measure?

• A. Kt/V per session only.
• B. Urine output alone.
• C. Serum creatinine level alone.
• D. Total weekly Kt/V or other solute clearance measures.

Answer: (D)

In peritoneal dialysis, adequacy is about how effectively waste products are cleared over time, not from a single session or a single lab value. The best measure combines all clearance sources to reflect true weekly cleansing of the body. That’s why total weekly Kt/V urea, which adds together peritoneal clearance and any remaining kidney function (along with other solute clearances like creatinine), is used. It gives a fuller picture of how much urea—and other small solutes—are being removed across the week.

Relying on a per-session Kt/V would miss fluctuations between exchanges and the contribution of residual renal function. Urine output alone only tells you about kidney function, not how much dialysis clearance is happening. Serum creatinine by itself doesn’t quantify how much solute is actually being removed by the dialysis process. While creatinine clearance can be useful, the standard practice is to look at the total weekly clearance measures, which capture the combined effect of peritoneal dialysis and any residual function.