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

Abstract

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.

Rate of Decline of Residual Kidney Function before and after the Start of Peritoneal Dialysis

“…In addition, we did not find that PD sub-modality was a risk factor for loss of RKF in the first year of PD. This agrees with most (23,29), but not all (30-32), studies. The use of icodextrin also did not influence RKF.…”

Strategies for preserving residual renal function in peritoneal dialysis patients

“…(2003) [ 36 ] 6-year prospective Incident 134 CAPD, 12 APD No Rodriguez-Carmona (2004) [ 62 ] 1-year prospective Incident 53 CAPD, 51 APD Yes Hazard ratio of APD versus CAPD = −1.2 (−2.25 to −0.15, P = 0.02) Rabindranath (2007) [ 63 ] Systematic review of 3 RCT 49 PD subjects No Liao (2009) [ 27 ] 10-year retrospective Incident 188 CAPD, 82 APD No Su et al . (2010) [ 64 ] 9-year retrospective Prevalent 140 CAPD, 32 APD No Cnossen et al . (2010) [ 55 ] 7-year retrospective Incident 179 CAPD, 441 APD No Balasubramanian et al .…”

The Effect of Automated versus Continuous Ambulatory Peritoneal Dialysis on Mortality Risk in China

“…In China, it is important to know whether the increased cost of APD is justified by improved outcomes. The weight of evidence suggests that APD has similar effects to continuous ambulatory PD (CAPD) in terms of residual renal function (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17), and either lower (2,(18)(19)(20)(21)(22)(23)(24) or similar (17,(25)(26)(27)(28)) rates of peritonitis. Older studies have mostly shown similar allcause mortality (2,7,25,(29)(30)(31)(32)(33).…”