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A multinational clinical validation study of PD ADEQUEST 2.0. PD ADEQUEST International Study Group.

E F Vonesh1, K O Story, W T O'Neill

  • 1Applied Statistics Center, Baxter Healthcare Corporation, Round Lake, Illinois 60073, USA.

Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis
|January 21, 2000
PubMed
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This study validates PD ADEQUEST 2.0, a kinetic modeling program for peritoneal dialysis (PD). The software accurately predicts patient clearances, aiding in optimizing PD prescription management for continuous ambulatory PD (CAPD) and automated PD (APD) patients.

Area of Science:

  • Nephrology
  • Biomedical Engineering
  • Clinical Informatics

Background:

  • Peritoneal dialysis (PD) requires precise management of solute clearance and fluid balance.
  • Kinetic modeling offers a potential tool for optimizing PD prescriptions.
  • Validation of new software is crucial for clinical adoption.

Purpose of the Study:

  • To clinically validate the PD ADEQUEST 2.0 kinetic modeling program.
  • To assess agreement between measured and modeled clearances (urea, creatinine), glucose absorption, drain volumes, and ultrafiltration in PD.
  • To evaluate the software's utility for all forms of PD.

Main Methods:

  • A multinational, prospective longitudinal study involving 104 adult patients on CAPD and APD.
  • Patients underwent a 4-hour peritoneal equilibration test (PET) with varying dextrose concentrations and fill volumes.

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  • Agreement assessed using correlation coefficients and Bland-Altman analysis between measured and modeled parameters.

    • Main Results:

    • Excellent agreement observed between measured and modeled urea Kt/V and creatinine clearance (CCr) (concordance correlation coefficients 0.83-0.97).
    • High agreement also found for glucose absorption and total drain volumes (concordance correlations 0.90 and 0.98).
    • Good agreement for net ultrafiltration (coefficient of clinical agreement 0.66-0.92).

    Conclusions:

    • PD ADEQUEST 2.0, combined with PET data, provides a powerful tool for CAPD and APD prescription management.
    • Kinetic modeling can expedite the optimization of dialysis doses for individual patients.
    • The software serves as a valuable adjunct to, not a replacement for, direct patient measurements.