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Evidence on continuous flow peritoneal dialysis: A review.
Joost C de Vries1, Maaike K van Gelder1, Gianni Cappelli2
1Department of Nephrology and Hypertension, University Medical Centre Utrecht, Utrecht, The Netherlands.
Seminars in Dialysis
|June 1, 2022
Summary
Continuous flow peritoneal dialysis (CFPD) shows promise for higher solute clearance but faces challenges. Novel systems using single-lumen catheters and rapid cycling require further clinical trials for validation.
Area of Science:
- Nephrology
- Biomedical Engineering
Background:
- Continuous flow peritoneal dialysis (CFPD) has potential benefits but limited clinical use due to technical hurdles.
- Existing CFPD systems often require dual-lumen catheters and large dialysate volumes, hindering adoption.
Approach:
- This review synthesizes current in vivo evidence on continuous flow peritoneal dialysis.
- Examines novel CFPD systems utilizing single-lumen catheters and rapid dialysate cycling.
- Considers advancements in on-demand dialysate generation and sorbent-based regeneration.
Key Points:
- CFPD demonstrates higher small solute clearance than conventional PD, especially at higher flow rates.
- Continuous glucose addition in CFPD enhances ultrafiltration and reduces peak intraperitoneal glucose concentrations.
- Reported patient discomfort and sterile peritonitis highlight tolerance issues.
Conclusions:
- Current evidence for CFPD is limited, primarily from small, non-uniform studies.
- CFPD via single-lumen catheters requires further investigation due to preliminary results.
- Well-designed, larger clinical trials are essential to establish CFPD's efficacy and safety.
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