How is peritoneal clearance typically assessed in PD patients?

• A. Daily serum phosphorus levels
• B. Weekly Kt/V urea and creatinine clearance, incorporating residual renal function to determine total clearance.
• C. Blood pressure monitoring
• D. Urine output alone

Answer: (B)

Clearance in PD is about how much solute is removed from the body over time, using the total amount cleared by both the peritoneal dialysis fluid and any remaining kidney function. In practice, this is assessed by looking at the weekly dose of urea removal (Kt/V) and by measuring total creatinine clearance, then adding the contribution from residual renal function to get the total clearance. Using weekly Kt/V urea captures how effectively solutes are being cleared over a week, and including residual renal function ensures that any kidneys still working are accounted for in the overall clearance. Creatinine clearance helps refine this estimate because creatinine is cleared somewhat differently than urea and provides a broader view of solute removal. This combined approach gives a more complete picture of dialysis adequacy than looking at urine output, blood pressure, or a single biomarker like phosphorus levels alone.