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Automated peritoneal dialysis: a Spanish multicentre study

A M Rodríguez1, N V Díaz, L P Cubillo

  • 1Service of Nephrology, Hospital Nuestra Señora del Pino, Las Palmas de Gran Canaria, Spain.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|October 7, 1998
PubMed
Summary

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Automated peritoneal dialysis (APD) offers superior peritoneal clearances compared to continuous ambulatory peritoneal dialysis (CAPD). The peritoneal equilibration test (PET) can predict APD clearances, with specific ratios indicating better outcomes.

Area of Science:

  • Nephrology
  • Renal Replacement Therapy
  • Dialysis Technology

Background:

  • Continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis (APD) are key renal replacement therapies.
  • Assessing peritoneal clearances and the predictive value of the peritoneal equilibration test (PET) for APD is crucial for optimizing treatment.

Purpose of the Study:

  • To compare peritoneal clearances across CAPD and three APD techniques.
  • To evaluate the influence of peritoneal permeability on nocturnal APD clearances.
  • To determine the suitability of the PET for predicting APD clearances.

Main Methods:

  • A prospective study involving 45 patients undergoing CAPD, continuous cycling peritoneal dialysis (CCPD), and tidal volume peritoneal dialysis (TPD) with varying tidal volumes.

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  • Patients underwent a PET, followed by evaluation of clinical, biochemical, and dialysis adequacy markers after 2 months on each modality.
  • Nocturnal clearances and dialysate to plasma (D/P) ratios were analyzed.
  • Main Results:

    • APD techniques demonstrated significantly higher peritoneal urea and creatinine clearances than CAPD.
    • CCPD provided the best nocturnal urea clearance, while CCPD and TPD (50% tidal volume) showed similar nocturnal creatinine clearance.
    • Significant differences were found between nocturnal D/P ratios and PET-derived ratios, with specific PET ratios effectively predicting nocturnal APD clearances.

    Conclusions:

    • TPD does not offer improved results over CCPD in terms of peritoneal clearances.
    • The PET is a valuable tool for predicting nocturnal clearances in APD, though direct nocturnal measurements reveal discrepancies with PET values.