| End-stage renal disease patients accumulate toxins, and causing metabolic disorders and a range of clinical symptoms in the end. There are three therapy methods is more recognized in the world, that is hemodialysis, peritoneal dialysis and renal transplantation. Continuous ambulatory peritoneal dialysis as a preferred blood purification therapy has entered clinical 30 years. With the constant evolution and improvement of technology and equipment, we have a higher demand of today to quality of life and survival conditionin. How to evaluate peritoneal dialysis sufficiency and how to improve it and how to extend the time of peritoneal dialysis,has become a hot spot of the current research. We have conducted a research regarding the subject of the adequacy of continuous ambulatory peritoneal dialysis.Objective: By learning about the peritoneal transport characteristics, we choice a appropriate program and adjust the dose of dialysis to enhance toxin clearance on peritoneal dialysis (KT/V and Ccr), and improve dialysis adequacy ultimately. Methods:50 patients with nephrology peritoneal dialysis were diagnosed in our hospital from January 2007 to December 2009. Recording 50 patients of the history taking, blood biochemistry before peritoneal dialysis and 24 hour urine volume; Complete peritoneal equilibration test within 3 months of regular peritoneal dialysis. Review the adequacy of peritoneal dialysis and nutritional status of patients and ask clinical symptoms, assess adequacy of peritoneal dialysis comprehensive and nutritional status of patients; To inadequate for dialysis patients, according to peritoneal transport type to develop the appropriate program of peritoneal dialysis, and assess the adequacy of peritoneal dialysis after follow-up 3 months. We conduct correlation analysis between objective indicators of dialysis adequacy (KT / V and Ccr) were associated with malnutrition and related factors of residual renal functionStatistical Methods: All of the data were analyzed by SPSS17.0 software. Statistic analysis: experimental data were denoted by average±standard deviation ( x±s), independent samples between the two groups were used t-test. Count data among groups were used Chi-aquare (χ2 )test, p<0.05 showed that variation was significant. the test standard for the bilateralα= 0.05.Results: (1) By peritoneal dialysis, the levels of toxic (BUN, CRE, P and PTH) were decreased, but the levels of HB and Ca2+ were increased, the variation was significant. (2) The type of peritoneal transport component ratio of the peritoneal dialysis patients in our hospital (H accounted for 14%, HA accounted for 46%, LA accounted for 38%, L 2%) is similar to literature reported. (3) Put empirical programs of peritoneal dialysis into use, there is 20 cases of peritoneal dialysis patients reach the target in 50 cases. According to PET, for the 30 patients whose peritoneal dialysis is inadequate at first, by adjusting peritoneal dialysis solutions and increasing dialysis dose, there are 16 peritoneal dialysis patients reach adequacy standards. (4) 50 patients were treated with modified SGA score: 27 cases of normal nutrition; 21 cases of mild to moderate malnutrition; 2 cases of severe malnutrition. (5) KTV is a positive correlation connected with PCR, ALB, RRF, RRF; Ccr was positively correlated with RRF. (6) Dialysate protein loss has nothing to do with the peritoneal transport type (P<0.05).Conclusion:(1) Not only can urea nitrogen, creatinine and other small molecule toxins be removed by peritoneal dialysis, but also the parathyroid hormone of toxin molecule can be cleared. It is an effective way of blood purification therapy.(2) Peritoneal dialysis can significantly improve the symptoms of uremia in patients with ESRD and improve anemia, correct calcium and phosphorus metabolism.(3) On the basis of the PET, adjusting the program of peritoneal dialysis or the dose of dialys, the adequacy of peritoneal dialysis can be improved.(4) KT/V is correlated positively with PCR, ALB and RRF; Ccr was positively correlated with RRF.
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