Which statement best describes how dialysis adequacy is assessed for hemodialysis and peritoneal dialysis?

• A. HD uses Kt/V per session; PD uses total weekly Kt/V or solute clearance measures.
• B. HD uses total weekly Kt/V; PD uses Kt/V per session.
• C. HD uses pretreatment serum urea; PD uses postdialysis clearance.
• D. HD uses urine output; PD uses creatinine clearance.

Answer: (A)

Dialysis adequacy is about whether the amount of solute removed matches the body's needs, but the way we measure that differs by modality. Hemodialysis treats each session as a separate event, so adequacy is assessed with Kt/V per session—the amount of urea cleared during that single treatment divided by the patient’s urea distribution volume. Peritoneal dialysis, on the other hand, runs continuously, so clearance is accumulated over the week. Adequacy is evaluated with a total weekly Kt/V (or total weekly solute clearance, which includes contributions from residual renal function). This difference reflects how each therapy delivers removal over time: discrete sessions for HD versus ongoing clearance for PD.