PD Prescriptions for Diabetics

Start the PD modality based on kinetic modeling and patient’s preference.

After the first month of therapy obtain:

  • 24-Hour Batch_v2.pdf to assess delivered dose
  • Clinical evaluation (hydration, nutrition, hypertension and glycemic control)
  • Adjust prescription for inadequate UF by:

                     –  Increasing the number of exchanges or reducing dwell time

                     –  Avoid prolonged exchanges

                     –  Consider NIPD if adequacy criteria are fulfilled

  • Adjust prescription for inadequate dose by:

                     –  Increasing exchange volume (Vip) as tolerated

                     –  Increase total dialysate volume and dialysis flow rate (DFR)

  • Adjust insulin according to glycemic control:

                     –  Increase dose of divided SQ insulin, insulin pump or IP insulin

                     –  Try to lower the glucose concentration by reducing dietary sodium and fluid intake,

                         improving glucose control, use of more frequent and shorter dialysis exchanges and

                         encourage regular exercise

  • Adjustments according to nutritional status:

                     –  Dietary counseling

                     –  Oral nutritional supplements