Patients on chronic peritoneal dialysis (PD) (including both
continuous ambulatory peritoneal dialysis [CAPD] and automated
forms of peritoneal dialysis [APD] such as continuous cycler
peritoneal dialysis [CCPD]) occasionally have difficulty
achieving solute removal goals or maintaining euvolemia. Both
inadequate solute removal and volume overload have multiple
etiologies. This topic reviews factors that contribute to
inadequate solute removal among PD patients and discusses the
clearance of particular solutes. This topic also reviews volume
overload among PD patients, and provides an approach to
evaluating such patients. The factors that regulate solute and
water transport across the peritoneal membrane are discussed
separately. (See "Mechanisms of solute clearance and
ultrafiltration in peritoneal dialysis".) The following
discussion assumes that the peritoneal dialysis prescription was
initially adequate and that solute clearance and/or fluid
removal have become impaired over time. A review of the factors