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The influence of automated peritoneal dialysis on the decrease in residual renal function.

G Hufnagel1, C Michel, G Queffeulou

  • 1Department of Nephrology, Hôpital Bichat and Association pour l'Utilisation du Rein Artificiel, Paris, France.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|May 27, 1999
PubMed
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Automated peritoneal dialysis (APD) shows a faster decline in residual renal function (RRF) compared to continuous ambulatory peritoneal dialysis (CAPD). Close monitoring of RRF is crucial for APD patients to ensure adequate dialysis.

Area of Science:

  • Nephrology
  • Renal Medicine
  • Dialysis Technology

Background:

  • Automated peritoneal dialysis (APD) is increasingly utilized in renal replacement therapy.
  • Previous studies suggested good preservation of residual renal function (RRF) in continuous ambulatory peritoneal dialysis (CAPD) patients.
  • This study investigates RRF preservation in APD patients compared to CAPD.

Purpose of the Study:

  • To compare the preservation of residual renal function (RRF) in patients undergoing Automated Peritoneal Dialysis (APD) versus Continuous Ambulatory Peritoneal Dialysis (CAPD).
  • To assess the rate of decline in renal function over one year in both APD and CAPD patient groups.

Main Methods:

  • Prospective study comparing 18 new APD patients (12 CCPD, 6 NIPD) with 18 matched CAPD patients over 1 year.

Related Experiment Videos

  • Residual renal function (RRF) assessed via normalized creatinine clearance (ml/min/1.73 m2) at baseline, 6 months, and 1 year.
  • Statistical comparison using Wilcoxon's rank sum test.

    • Main Results:

    • APD patients experienced a significantly faster monthly decrease in creatinine clearance (-0.28 ml/min at 6 months, -0.26 ml/min at 1 year) compared to CAPD patients (-0.1 ml/min and -0.13 ml/min, respectively).
    • No significant difference in ultrafiltration rates was observed between APD and CAPD.
    • APD patients used a higher daily instilled volume of hypertonic glucose solution.

    Conclusions:

    • Residual renal function (RRF) declines rapidly in APD patients, unlike the preservation seen in CAPD patients.
    • The intermittent nature of APD and increased use of hypertonic dialysate may contribute to faster RRF decline.
    • Close monitoring and adjustment of APD prescriptions are recommended to maintain dialysis adequacy.