Related Experiment Videos
Automated peritoneal dialysis: new implications for pharmacists
1Virginia Commonwealth University School of Pharmacy, Medical College of Virginia, Richmond 23298, USA. dbrophy@gems.vcu.edu
The Annals of Pharmacotherapy
|June 1, 1997
Summary
Automated peritoneal dialysis (APD) is a growing treatment for end-stage renal disease (ESRD). Current drug dosing relies on continuous ambulatory peritoneal dialysis (CAPD) guidelines due to a lack of specific APD pharmacokinetic studies.
Area of Science:
- Nephrology
- Pharmacology
- Renal Replacement Therapy
Background:
- End-stage renal disease (ESRD) necessitates renal replacement therapy.
- Automated peritoneal dialysis (APD) is a rapidly expanding treatment modality for ESRD.
- APD offers improved patient convenience and adherence while reducing peritonitis rates.
Purpose of the Study:
- To review emerging automated peritoneal dialysis (APD) modalities.
- To examine the pharmacokinetic and drug dosing implications of APD.
- To compare APD with continuous ambulatory peritoneal dialysis (CAPD).
Main Methods:
- Conducted a MEDLINE search of English-language literature (1966-1996) on peritoneal dialysis.
- Reviewed bibliographies of pertinent articles and tertiary sources.
- Extracted and evaluated data on APD techniques and pharmacokinetics.
Main Results:
- APD is the fastest-growing renal replacement therapy in the US.
- No formal drug dosing recommendations exist for APD.
- Pharmacists currently use CAPD guidelines for APD dosing.
- Pharmacokinetic differences between CAPD and APD require further investigation.
Conclusions:
- Further well-designed studies are essential to define APD drug pharmacokinetics.
- Administer intraperitoneal drugs during the longest dwell time.
- Closely monitor serum drug concentrations for agents with narrow therapeutic indices.