Double bag or Y-set versus standard transfer systems for continuous ambulatory peritoneal dialysis in end-stage kidney disease

Daly, Conal; Cody, June D; Khan, Izhar; Rabindranath, Kannaiyan S; Vale, Luke; Wallace, S

doi:10.1002/14651858.cd003078

Cited by 24 publications

(23 citation statements)

References 34 publications

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“…Over these years, two important changes were made in the care of PD patients, namely the use of the disconnect system since 1994 and the use of biocompatible solutions since 2005. Several previous reports have suggested that PD device advancement from a single bag to twin‐bag systems has reduced the incidence of touch contamination causing PD‐associated peritonitis . Our data showed that twin‐bag systems have had a favorable effect on the incidence of PD‐associated peritonitis, as was also reported by van Esch et al .…”

Section: Discussionsupporting

confidence: 87%

“…As previously identified, changing from single‐bag to twin‐bag systems specifically reduced infection with Staphylococcus sp. , as well as PD‐associated peritonitis, at a global level. Pseudomonas aeruginosa accounted for 13.2% of PD‐associated peritonitis episodes between 1995 and 1999 in Hong Kong, and for 5.3% of cases between 2003 and 2006 in Australia .…”

Section: Discussionmentioning

confidence: 99%

“…Several preventive strategies have been developed for these complications, focusing on the modalities and technologies applied. For example, PD device advancement from single‐bag to twin‐bag systems mitigates the impact of touch contamination causing PD‐associated peritonitis . In addition, the switch to biocompatible PD solutions, characterized by neutral pH and low glucose degradation product (GDP) content, from conventional PD solutions appeared to be protective against peritoneal membrane damage and ultrafiltration failure .…”

mentioning

confidence: 99%

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33 Years of Peritoneal Dialysis‐Associated Peritonitis: A Single‐Center Study in Japan

et al. 2015

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Peritoneal dialysis-associated peritonitis (PD-associated peritonitis) could influence the outcome of PD patients, including technique survival. Although the use of the twin-bag system has decreased the incidence of peritonitis, the effects of biocompatible PD solutions are controversial. Additionally, since both infection-causing microorganisms and antimicrobial therapies have changed over time, the duration of treatment of peritonitis (the duration of peritonitis) seems to have changed. The study included 527 patients who received PD between January 1980 and December 2012 at a single center. We divided patients undergoing PD into three groups according to the type of PD system used, namely single-bag and conventional PD solutions (S+C group, N = 145), twin-bag and conventional PD solutions (T+C group, N = 171) and twin-bag and biocompatible PD solutions (T+B group, N = 211), and analyzed PD-associated peritonitis incidences. Incidences of PD-associated peritonitis (times per patient-months) and peritonitis-free time were 1/59.4, 1/70.6 and 1/103.1, and 52, 97, and 100 months for the S+C, T+C and T+B groups, respectively. The duration of peritonitis, has thus, become dramatically shorter in recent years. Streptococcus sp. were associated with shortest and fungi with longest durations of peritonitis. Staphylococcus sp. and Pseudomonas aeruginosa were predominant in the S+C group. The twin-bag system has made a greater contribution to reductions in PD-associated peritonitis than biocompatible PD solutions. Furthermore, changes in microorganisms, antimicrobial therapies, patient education and improved PD system devices have presumably affected the reduction in the duration of peritonitis.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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33 Years of Peritoneal Dialysis‐Associated Peritonitis: A Single‐Center Study in Japan

et al. 2015

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“…The twin bag system is the only CAPD setup available today in most parts of the world and is the dominant reason for the reduction in risk for peritonitis in individuals undergoing PD. 31 Improvements in connection systems for APD lagged behind those for CAPD: for a while, when use of twin-bag systems became the standard of care for CAPD, individuals undergoing APD still had to spike the bags manually. However, connection systems for APD have evolved over time, first with the introduction of connection assist devices and now with the use of Luer lock connections.…”

Section: Peritonitismentioning

confidence: 99%

Comparative Outcomes Between Continuous Ambulatory and Automated Peritoneal Dialysis: A Narrative Review

Bieber

Burkart

Golper

et al. 2014

American Journal of Kidney Diseases

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Automated methods for delivering peritoneal dialysis (PD) to persons with end-stage renal disease continue to gain popularity worldwide, particularly in developed countries. However, the endeavor to automate the PD process has not been advanced on the strength of high-level evidence for superiority of automated over manual methods. This article summarizes available studies that have shed light on the evidence that compares the association of treatment with continuous ambulatory PD or automated PD (APD) with clinically meaningful outcomes. Published evidence, primarily from observational studies, has been unable to demonstrate a consistent difference in residual kidney function loss rate, peritonitis rate, maintenance of euvolemia, technique survival, mortality, or health-related quality of life in individuals undergoing continuous ambulatory PD versus APD. At the same time, the future of APD technology appears ripe for further improvement, such as the incorporation of voice commands and expanded use of telemedicine. Given these considerations, it appears that patient choice should drive the decision about PD modality.

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“…The Cochrane database of systematic reviews at the University of York, UK provides a range of systematic reviews undertaken within the field of nephrology (7,8). One review, which should prompt an increasing search for evidence, was a review to assess the benefits and harms of CAPD versus hospital or home haemodialysis for adults with ESRD (9).…”

Section: Application Of Evidence-based Practice To Nephrologymentioning

confidence: 99%

Evidenced Based Nephrology Care

Sedgewick

2003

EDTNA-ERCA Journal

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This paper highlights the importance of evidenced-based practice (EBP) and its implications to patient and health professionals working within nephrology. The need to ensure that practice is based upon best evidence should be a concern for all health care professionals. Confusion sometimes surrounds the concept of EBP and the potential impact this may have upon patient outcomes. It is the intention of this paper to firstly demystify the process of EBP highlighting the important factors to be considered in moving towards EBP in nephrology care. Secondly, the paper draws upon a number of well-conducted research studies, which have important implications for nephrology care. These selected examples of best evidence will highlight further where ongoing work could be focused. Whilst there is much published within current literature concerning research within nephrology it is essential that practitioners are encouraged to develop the skills to critically search literature, appraise and evaluate its usefulness in developing appropriate and meaningful evidence to enhance practice and patient care.

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Double bag or Y-set versus standard transfer systems for continuous ambulatory peritoneal dialysis in end-stage kidney disease

Cited by 24 publications

References 34 publications

33 Years of Peritoneal Dialysis‐Associated Peritonitis: A Single‐Center Study in Japan

33 Years of Peritoneal Dialysis‐Associated Peritonitis: A Single‐Center Study in Japan

Comparative Outcomes Between Continuous Ambulatory and Automated Peritoneal Dialysis: A Narrative Review

Evidenced Based Nephrology Care

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