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Related Experiment Videos

Incremental dialysis with automated peritoneal dialysis.

Loris Neri1, Giusto Viglino, Agnese Cappelletti

  • 1Ospedale San Lazzaro, Alba, Italy.

Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis
|February 7, 2004
PubMed
Summary

Low-frequency automated peritoneal dialysis (LF-APD) is a viable incremental dialysis option for patients with reduced kidney function. This approach demonstrated good compliance and no peritonitis, supporting its use as a first renal replacement therapy.

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Area of Science:

  • Nephrology
  • Renal Replacement Therapy

Background:

  • Incremental dialysis is proposed for patients with a glomerular filtration rate (GFR) of 8-9 mL/min/1.73 m2.
  • Automated peritoneal dialysis (APD) offers a flexible treatment modality.

Purpose of the Study:

  • To evaluate the efficacy and feasibility of low-frequency APD (LF-APD) as an incremental dialysis strategy.
  • To assess patient compliance and outcomes with LF-APD.

Main Methods:

  • Five patients with GFR 8-9 mL/min/1.73 m2 were initiated on LF-APD (3-4 days/week).
  • Treatment parameters included dwell volume, use of icodextrin, and abdomen status.
  • Residual renal function (RRF) and dialysis adequacy (PET) were monitored regularly.

Main Results:

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  • Three patients remained on LF-APD for 15-25 months with stable GFR.
  • One patient required increased APD frequency due to underdialysis.
  • One diabetic patient experienced GFR decline and transitioned to hemodialysis.
  • No peritonitis episodes occurred over 84 patient-months; compliance was total.

Conclusions:

  • LF-APD is a safe and effective incremental dialysis option.
  • It can facilitate patient choice for peritoneal dialysis as initial renal replacement therapy.
  • LF-APD supports sustained renal function and treatment adherence.