[From CANUSA to ADEMEX: do we need a new paradigm for definition of peritoneal dialysis adequacy?]

Abstract

Peritoneal dialysis doses were prescribed out of empirical criteria up to the mid-Ninety Then, the observational CANUSA study and the experimental ADEMEX study helped to define adequacy criteria according to urea kinetics model. This review analyzes the limits of a definition of adequacy grounded exclusively on urea kinetics, as well as the need for new parameters of adequacy. The evidence is presented fostering the hypothesis that the control of extra-cellular fluid excess and of other cardiovascular risk factors may now be considered a new target for adequacy.