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Patient selection for automated peritoneal dialysis: for whom, when?
Vassilios Liakopoulos1, Nicholas Dombros
1Department of Nephrology, Medical School, University of Thessaly, Larissa, Greece.
Summary
Automated peritoneal dialysis (APD) offers flexibility and improved treatment targets, especially for high transporters and those needing assistance. However, its medical benefits beyond specific cases remain debated, with patient choice being key.
Area of Science:
- Nephrology
- Medical Technology
Background:
- Automated peritoneal dialysis (APD) use has risen due to technological advancements and patient lifestyle integration.
- APD offers flexibility, improved dialysis adequacy, and ultrafiltration compared to other modalities.
Purpose of the Study:
- To review the increasing use of automated peritoneal dialysis (APD).
- To evaluate the benefits and drawbacks of APD in various patient populations.
- To discuss the suitability of APD as an alternative dialysis option.
Main Methods:
- Review of current literature and clinical practice regarding automated peritoneal dialysis (APD).
Main Results:
- APD is suitable for high transporters and patients requiring assistance (pediatric, elderly).
- Associated benefits include improved compliance, lower intraperitoneal pressure, and reduced peritonitis.
- Concerns include complexity, cost, faster decline in residual renal function, and inadequate sodium removal.
Conclusions:
- APD is a viable option for those needing higher dialysis doses or urgent starts.
- Medical advantages of APD are controversial outside of high transporters.
- Individual patient preference should guide APD application, ensuring its availability to all new peritoneal dialysis patients.
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