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[Automatic peritoneal dialysis--an adequate therapy option for the treatment of terminal kidney failure. First
1Klinik für Nephrologie und Rheumatologie, Universität Düsseldorf.
Objective:
To determine whether (1) the recently developed pneumatic cycler for automatic peritoneal dialysis (APD) achieves individually adjustable adequate dialysis efficacy, and (2) changing from continuous ambulatory peritoneal dialysis (CAPD) to APD results in an appropriate increase of dialysis efficacy.
Patients And Methods:
Between July 1994 and August 1995 dialysis treatment for chronic renal failure was performed in 17 patients (four women, 13 men: mean age 42.9 +/- 11.6 years). Ten patients decided primarily on APD, seven changed over from CAPD to APD because of inadequate dialysis efficacy. Adequacy of dialysis was judged by clinical criteria, weekly creatinine clearances (wCcr) and urea levels (urea elimination related to distribution volume [wKT/V]).
Results:
Mean treatment period with APD was 7.9 +/- 0.3 hours, dialysate volume 19.4 +/- 2.3 1. An ultrafiltration of 1253 +/- 643 ml was achieved. Mean serum creatinine was 13.1 +/- 3.5 mg/dl, mean serum urea-nitrogen 61 +/- 15 mg/dl. wCcr was 78.6 +/- 27.2 1, wKT/V 2.21 +/- 0.33. All patients were adequately dialysed with various forms of APD. In those patients who changed from CAPD the dialysis efficacy, judged by weekly urea-nitrogen elimination, increased by 50% from 1.42 +/- 0.29 to 2.14 +/- 0.20 (P < 0.05). With the pneumatic cycler the different dialysis modes were achieved without problem.
Conclusion:
APD with the new pneumatic cycler provided an adequate and attractive option, from both medical and psychosocial aspects, in the dialysis of patients in chronic renal failure. Changing from CAPD to APD in certain patient groups clearly increased dialysis efficacy so that changing over to haemodialysis can often be avoided.