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Related Experiment Videos

Enhanced peritoneal dialysis delivery with PD-PLUS.

C Cruz1, F Dumler, R Schmidt

  • 1Henry Ford Hospital, Detroit, Michigan.

Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis
|January 1, 1992
PubMed
Summary
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Enhanced continuous ambulatory peritoneal dialysis (CAPD) improved protein levels in patients with no kidney function. Adding a fifth nighttime exchange using automated device (PD-PLUS) boosted normalized protein catabolic rate (NPCR).

Area of Science:

  • Nephrology
  • Renal Medicine
  • Dialysis Technology

Background:

  • Patients with end-stage renal disease and zero residual renal function often face challenges in maintaining adequate nutritional status.
  • Urea kinetic modeling is crucial for assessing dialysis adequacy, with Kprt/V and normalized protein catabolic rate (NPCR) as key indicators.
  • Current continuous ambulatory peritoneal dialysis (CAPD) protocols may require optimization for specific patient populations.

Purpose of the Study:

  • To investigate the impact of an enhanced CAPD regimen on NPCR and Kprt/V in patients with no residual renal function.
  • To evaluate the efficacy of an automated device for delivering an additional nighttime CAPD exchange.

Main Methods:

  • A prospective study involving two patients with zero residual renal function and suboptimal urea kinetic modeling parameters.

Related Experiment Videos

  • Implementation of enhanced CAPD by adding a fifth nighttime exchange using a portable, automated device (PD-PLUS).
  • Monitoring of NPCR and Kprt/V before and after the intervention period.

    • Main Results:

    • Both patients demonstrated predictable increases in NPCR after two weeks of enhanced CAPD.
    • NPCR values rose from 0.61 to 0.76 gm/kg/day and from 0.73 to 0.81 gm/kg/day.
    • The addition of a fifth nighttime exchange was successfully achieved using the automated PD-PLUS device.

    Conclusions:

    • Enhanced CAPD, incorporating an additional nighttime exchange via an automated device, effectively improves NPCR in patients with no residual renal function.
    • This strategy offers a practical approach to optimizing nutritional management in CAPD patients.
    • Automated devices can facilitate enhanced dialysis regimens, potentially improving patient outcomes.