Individualized PD prescription: APD versus CAPD

The proportion of patients performing automated peritoneal dialysis (APD) is increasing worldwide, a development probably caused by the better possibilities of adapting APD to the patients' individual needs with respect to private life as well as dialysis adequacy. Patients prefer the independence from dialysis during the day and report a higher quality of life compared to patients on continuous ambulatory peritoneal dialysis (CAPD). In case of declining clearance rates, Kt/V, or sodium removal rates, a change in the APD regimen, together with higher fill volumes and, for example, combination with daytime CAPD, offers the tools to increase the dialysis dose as required by the individual clinical situation. The development of an online dialysis solution production system for APD could even improve the possibilities of individualizing peritoneal dialysis by providing variable concentrations of glucose, sodium, and bicarbonate buffer.