This is a very bordeline practice and mainly experimental, albeit interesting from a theoretical point of view. One problem is the reluctance for a patient to have two catheters instead of a single one. There is possibility to use a double lumen catheter but it needs to be slightly larger and there is the risk of local recirculation if in and out extremities are too close. Previous experiences demonstrate an increase in small molecules clearances, but it is well known that in renal failure it's increasing middle molecules clearances which is the most important. However this technic deserves to be evaluated especially for designing continuous wearable kidney. To summize and reply to the question : No, we are far from using continuous flow peritoneal dialysis in adults.
I have used CFPD over the years in selected patients (see recent publication). We recently treated a 62 year old man with AKI from cirrhosis with CFPD by dialyzing his ascites through an external HD circuit. We used a novel, dual lumen catheter designed by Claudio Ronco's group in Vicenza. We obtained urea clearances of 30-50 ml/min and sustained this patient for over 6 months on 5-6 treatments per week of 5-6 hours each. He recently expired from recurrent, severe GI bleeding. The technique has potential in treatment of AKI, and as a competitor with home HD for chronic therapy.
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