On our center our patients on CCPD plus do not connect to the cycler to do the daytime dwell, they do a manual exchange, many times due to personal constraints. We should add a sample of that dialysate to the sample of the cycler the patient collects to calculate a precise kt/v.
How should we do the ratio of volume of that manual dwell to add to the sample they bring of the night dwell from the cycler, in order to calculate the correct kt/v? How many mL should the patient collect of that bag and of the nighttime dwell?
Yes, it is a tricky issue - we've faced it too, when started our CCPD program. Our way was to collect ALL the dialysate into the same bag (that's it - day dwell included). In some cases the provided collection bag was not sufficient - then we used the empty HD concentrate canisters and it worked well. Not ideal, and required some manual work, but at least all the dialysate was collected into single volume, the volume ratio therefore was natural, and we were able to use one mixed sample for lab analysis. Hope it helps
Thank you! That's a new idea to solve this problem, we are asking 2 separate samples and then trying to do a proportional mixing, but as you understand it's not easy and it is prone to error... I will present that option to the team, thank you.
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