What is the typical adult PD fill volume per exchange and how is it determined?

• A. About 3.5 L per exchange; fixed for all adults.
• B. About 2 L per exchange for an average adult; volumes adjusted based on body size, abdominal capacity, tolerance, and risk of leaks.
• C. About 1 L per exchange; adjusted by age only.
• D. About 4 L per exchange; based on residual renal function.

Answer: (B)

In PD, the fill volume per exchange is not fixed; it’s about 2 liters for an average adult, but is individualized. The amount is chosen based on body size and abdominal capacity, how comfortable the patient feels, and the risk of leaks or pressure-related issues. Larger individuals or those with more abdominal space may tolerate slightly higher volumes, while smaller people or those with limited abdominal capacity may need less. If the volume is too high, it can cause discomfort, breathing difficulty, or leaks around the catheter. If too low, clearance may be inadequate. So the best approach is to tailor the fill volume to the person’s size, tolerance, and safety, typically around 2 L per exchange for an average adult, with adjustments as needed.