[Cyclers for APD: current potential and possible developments]

The use of automated peritoneal dialysis (APD) is rapidly increasing worldwide. The success of this treatment is closely linked to the development of new mechanical devices (cyclers). At present, the cyclers available in Italy are the Baxter Home Choice Pro, the Fresenius Sleep Safe, and the Gambro Serena. Today's cyclers are characterized by a user-friendly, intuitive interface and sophisticated software. The miniaturization of components has led to a significant reduction of the weight and size of these machines and great flexibility in treatment scheduling. The memory card (patient card) and the possibility of remote control (teledialysis) allow continuous monitoring of the patients and their compliance to treatment. The cyclers of the future could optimize their performance by biosensors able to assess, in real time, the dialysis dose while sensors placed on the drainage line could facilitate the early diagnosis of peritonitis. The peritoneal clearance could be increased with the development of continuous-flow peritoneal dialysis (CFPD). Finally, the introduction of cyclers able to prepare individually tailored solutions different from the standard ones could better meet the clinical needs of the patients and reduce the exposure of the peritoneal membrane to high concentrations of glucose.