Automated Peritoneal Dialysis Symposium: APD Prescription: Achieving the Adequacy Goals

Abstract

In the last few years, automated peritoneal dialysis (APD) has undergone considerable improvements due to technological developments. The definition of a minimal dose of peritoneal dialysis (PD) has not yet been completely assessed. Appropriate use of APD requires an evaluation of dialytic efficiency in terms of dialytic indexes and their targets. Many dialytic treatment modalities have been performed in order to achieve adequacy targets. Some aspects have to be taken into consideration to reach the optimal dialytic dose: optimizing mass transfer in correlation with intraperitoneal volumes, prescribing tailored treatment modalities according to different characteristics of peritoneal membranes and individual patient needs, and performing more biocompatible treatments using different glucose profiling and alternative physiologic PD fluids. New high-flow techniques such as continuous flow PD can ensure better urea and creatinine clearances and ultrafiltration rates, leading to a higher utilization of the APD modality.

Research hotspots and emerging trends of automated peritoneal dialysis: A bibliometric analysis from 2000 to 2020

“…The keyword with the strongest citation strength was “adequacy” (9.91), and it lasted for the initial years (2000–2004). An article summarized some possible means to achieve the desired adequacy targets, including establishing individual APD prescriptions and using PD techniques 43 . The keyword “outcome” was the second strongest word (6.14) and also has the longest duration for 10 consecutive years since 2010.…”

“…An article summarized some possible means to achieve the desired adequacy targets, including establishing individual APD prescriptions and using PD techniques. 43 The keyword "outcome" was the second strongest word (6.14) and also has the longest duration for 10 consecutive years since 2010. The keywords "technique failure" and "patient survival" are similar to "outcome," which suggested that the prognosis of patients has always been the main topical subject in APD research.…”

Trends in Automated Peritoneal Dialysis Prescriptions in a Large Dialysis Organization in the United States

“…18 Although sometimes difficult to obtain, given the associated time burden to patients and clinical staff, 19 results of peritoneal equilibration test should also guide APD prescriptions. 20 Patients exhibiting high solute transport are well suited for shorter dwell times and nocturnal APD, whereas those with low transport generally require longer dwell times. In this analysis, high transporters were treated with more nighttime cycles, shorter dwell times per cycle, and a marked increase in total nighttime treatment volumes.…”