Automated vs continuous ambulatory peritoneal dialysis: a systematic review of randomized controlled trials

Rabindranath, Kannaiyan S; Adams, James M.; Ali, Tariq; Daly, Conal; Vale, Luke; MacLeod, Alison Murray

doi:10.1093/ndt/gfm515

Cited by 103 publications

(107 citation statements)

References 25 publications

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“…[8][9][10][11]14 However, the evidence with respect to the effect of APD on peritonitis when compared to CAPD is controversial because the majority of these studies were observational studies and hence prone to biases; therefore, their results may not be entirely reliable. 15 Our results did not demonstrate the superiority of APD to CAPD in reducing episodes of peritonitis. In other words, we may conclude that selection of the PD modality was not a major determinant of peritonitis incidence.…”

Section: Discussioncontrasting

confidence: 72%

Comparison of clinical characteristics between automated peritoneal dialysis and continuous ambulatory peritoneal dialysis: a 2-year single-center observational study

Lee

Chuang

et al. 2010

Renal Failure

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Aims: To date, there is convincing evidence for the preservation of residual renal function (RRF) in peritoneal dialysis (PD) patients; however, substantially variable data exist on the incidence rate of infectious complications and the decline of RRF for automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD). The purpose of our study was to investigate the relative merits or demerits of APD compared with CAPD. Methods: From November 1998 to November 2007, we retrospectively reviewed 32 patients on APD and 140 patients on CAPD. We compared incidences of infectious complications during the entry period. RRF and other PD parameters were determined and compared over 2 years of therapy. In addition, the period of hospitalization was also included for clinical outcome analysis. Results: There were no significant differences between the two modalities with regard to the incidence of peritonitis (1.42/100 patient-months for APD vs. 1.23/100 patient-months for CAPD, p = 0.66). At the end of the second year, there were no significant differences between APD and CAPD with regard to the decline of RRF (14.8 vs. 15.3 L/week/1.73 m 2 , p = 0.84). However, APD significantly increased the value of total weekly Kt/V during this period. Furthermore, we observed a significant reduction in hospitalized days of APD compared with CAPD. Conclusions: We concluded that the selection of the PD modality is not a major determinant of the decline in RRF. APD can be adapted to the targeted adequacy and is at least as efficacious as CAPD when it is expertly applied.

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Section: Discussioncontrasting

confidence: 72%

Comparison of clinical characteristics between automated peritoneal dialysis and continuous ambulatory peritoneal dialysis: a 2-year single-center observational study

Lee

Chuang

et al. 2010

Renal Failure

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“…CAPD modality at FUNDANIER had a higher reported peritonitis rate than APD, which is similar to what has been shown in other studies [22]. This may be due to the number of connection and disconnection events (fewer in APD compared to CAPD) [3,22].…”

Section: Discussionsupporting

confidence: 82%

Risk Factors for Peritonitis in a Pediatric Dialysis Program in Guatemala, 2011–2014

Chinchilla¹,

Sebastián²,

Meléndez

et al. 2016

Advances in Nephrology

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Background. Peritonitis is the most common complication of peritoneal dialysis but there is limited data regarding peritonitis related risk factors in developing countries. Objective. Describe the PD program at Foundation for Children with Kidney Disease (FUNDANIER), in Guatemala, and identify peritonitis related risk factors in these patients. Methods. This retrospective open cohort study included medical records from FUNDANIER during 2011 to 2014. Baseline demographics, treatment modalities, caregivers' characteristics, and socioeconomic status were recorded. Results. Eighty-nine medical records were included with a treatment time of 1855 months. Median age of patients was 11.3 years (range 6-17). Median duration of PD therapy was 20.8 months (range 1-28). Sixty-eight peritonitis episodes were registered; forty-eight patients (54%) remained peritonitis-free. Median time to first peritonitis episode was 5 months (range 2-16). Peritonitis rate was one episode every 27 months or 0.44 episodes per patient-year. Peritonitis rate in patients with fair housing was 2.5 times higher than in those with good housing (CI = 1.0-5.2, = 0.01). Conclusion. Housing conditions are a relevant risk factor related to peritonitis. Strategies toward preventing peritonitis must consider housing status, establishing adequate follow-up in high-risk patients. Close monitoring of technique serves to overcome understaffing issues in this setting.

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“…The number of patients was relatively small: the largest study comprised 50 patients in the largest group (11). These were reviewed in 2006 (13,14), and no significant differences in survival were found.…”

mentioning

confidence: 99%

Similar Survival on Automated Peritoneal Dialysis and Continuous Ambulatory Peritoneal Dialysis in a Large Prospective Cohort

Michels

Verduijn

Boeschoten

et al. 2009

Clinical Journal of the American Society of Nephrology

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Background and objectives: Automated peritoneal dialysis (APD) is increasingly used in comparison with continuous ambulatory peritoneal dialysis (CAPD). Although APD is expected to improve survival, convincing evidence of major advantages is lacking. The objective was to investigate whether overall mortality and technique failure of incident dialysis patients treated with APD are different from those treated with CAPD.Design, setting, participants, & measurements: Patients on APD or CAPD at 3 mo after start of dialysis were selected from a prospective multicenter cohort study in incident dialysis patients (NECOSAD). Overall mortality was studied with an intention-to-treat design; the event was death. Technique failure was studied with an as-treated design; the event was a switch of dialysis modality. Hazard ratios (HRs) were calculated with a follow-up of 5 yr. The HRs were adjusted for gender, age, primary kidney disease, comorbidity, residual GFR, urine production and plasma albumin at 3 mo after inclusion.Results: Eighty-seven APD and 562 CAPD patients were included. In the intention-to-treat analysis 154 CAPD and 21 APD patients died. The crude HR for overall mortality was 0.98 (95% CI: 0.62-1.54), the adjusted HR was 1.09. In the as-treated analysis 238 CAPD and 34 APD patients switched therapy, whereas 91 CAPD and 7 APD patients died. The crude HR for technique failure was 0.92 (95% CI: 0.64 -1.31) and did not change after adjustment.Conclusions: No difference was found in overall mortality and technique failure for APD compared with CAPD in incident dialysis patients.

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Automated vs continuous ambulatory peritoneal dialysis: a systematic review of randomized controlled trials

Cited by 103 publications

References 25 publications

Comparison of clinical characteristics between automated peritoneal dialysis and continuous ambulatory peritoneal dialysis: a 2-year single-center observational study

Comparison of clinical characteristics between automated peritoneal dialysis and continuous ambulatory peritoneal dialysis: a 2-year single-center observational study

Risk Factors for Peritonitis in a Pediatric Dialysis Program in Guatemala, 2011–2014

Similar Survival on Automated Peritoneal Dialysis and Continuous Ambulatory Peritoneal Dialysis in a Large Prospective Cohort

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