Would you recommend adding a daytime dwell over an additional nighttime exchange to achieve volume and clearance targets for an ESKD patient who recently stopped making urine and has been receiving only nighttime automated peritoneal dialysis?

Regardless of fluid removal needs, once a patient on automated peritoneal dialysis (APD) has lost their residual kidney function, they should have a long dwell added to their PD regimen sometime during the day in order to facilitate peritoneal clearance of phosphorus and middle molecules.

The native ...

This is a tough one.

My approach is to make the best of the night first before "last bag fill" (daytime dwell). Adding an exchange does help but just adding time that may be required with that extra exchange can take away the QOL advantage of PD. You can shorten the dwell times of all of them but th...

To get to the point right away, there is no evidence that any form of PD is safe in anuric ESRD patient who do not have peritoneal exposure to dialysate 24 hr/d. Remember that we do not know why PD works even while providing a Kt/V far less than a clinically equivalent dose of HD. One highly reasona...