TOPIC DISCUSSION: TIDAL PD

Tidal Peritoneal dialysis introduced in 1990 is a technique in which an initial infusion of solution into the peritoneal cavity is followed after a short dwell time with drainage of only a portion of the dialysate.Part of the dialysate also referred to as the "reserve volume" remains in constant contact with the peritoneal membrane.Rationale to introduce this technique was to improve dialysis efficiency by reducing time lost during inflow and outflow of dialysate and to improve clearances because of the constant contact between dialysate and peritoneal membrane although no study has shown any conclusive evidence to support or refute above due to numerous variables that affect dialysis efficacy and small sample size in each study.
Tidal volume during this modality should be kept as high as possible especially in those with low average peritoneal transport rates.
Its role may be limited in the present time to provide comfort to the patient owing to fewer alarms and less pain during inflow and outflow with the significant drawback of need for higher dialysate volumes and therefore higher incurred costs.
References
Tidal peritoneal dialysis:comparison of different tidal regimens and automated peritoneal dialysis.KI,Vol 57(2000),2063-2607
The role of tidal peritoneal dialysis in modern practice:A european perspective KI Suppl.2006 Nov;(103):S96-S103