The invention relates to devices, systems, and methods for performing a precision or personalized Peritoneal Dialysis (PD) therapy session or cycle based on dialysis adequacy measurements in patients undergoing peritoneal dialysis treatment. The settings for the precision peritoneal dialysis therapy session can be obtained using one or more flow sensors and one or more uremic solute sensors that measure the uremic solute concentration and volume of the peritoneal dialysate removed from the patient. The desired dialysis adequacy for a specific patient, group of patients, or class of patients, can then be calculated based on the measured peritoneal dialysate concentration and volume. Using the calculated dialysis adequacy, the system and methods can then set one or more peritoneal dialysis parameters for subsequent cycles or sessions.