Cross-Over Efficiency Comparison of Different Tidal Automated Peritoneal Dialysis Schedules

Abstract

This study compares 5 different tidal automated peritoneal dialysis (APD) prescriptions. Six low-average and 6 high-average transporters performed 3 separate sessions with 5 different schedules: (A) 50% tidal with initial fill volume (FV) 2 liters, (B) 50% tidal with 2.2 liters initial FV, (C) 2.2 liters initial FV with 70% tidal, (D) as in B, with one complete renewal of the initial FV at midsession, (E) 2.2 liters FV with breakpoint modality. Urea, creatinine and phosphate peritoneal clearances, sodium removal and ultrafiltration (UF) were compared using analysis of variance. Compared to treatment A, all the tested alternative schedules were associated with 10% significantly higher urea clearance; B, D and E, but not C, were associated with 10% higher creatinine clearance. Phosphate clearance was significantly higher with D, while sodium removal was larger with both C and D. UF was lower with A and E in high average transporters. Manipulation of the main prescriptive parameters of tidal APD has significant impact on its efficiency.

Grafting of Crown Ether and Cryptand Macrocycles on Large Pore Stellate Mesoporous Silica for Sodium Cation Extraction

“…Cryptand 221 was prepared from the hydrolysis of its tertiobutyl-ester precursor, i.e., Cryptand 221 -OBu prepared from experimental procedures described in the literature ( Scheme 2 ) [ 48 ]. Cryptand 221 -OBu was characterized by 1 H NMR and mass analysis.…”

“…The supernatants were analyzed by induced coupled plasma atomic emission spectroscopy analysis with a Varian 720 ES instrument (ICP-AES). Cryptand221 was prepared from the hydrolysis of its tertiobutyl-ester precursor, i.e., Cryptand221-OBu prepared from experimental procedures described in the literature (Scheme 2) [48]. Cryptand221-OBu was characterized by 1 H NMR and mass analysis.…”

Phosphate Control in Peritoneal Dialysis Patients: Issues, Solutions, and Open Questions

“…Compared to a 50% tidal with an initial fill volume of 2 liters, a 50% tidal prescription with 2.2 L of initial fill volume and one complete renewal of the latter at midsession was associated with a significantly higher phosphate clearance. The most likely reason is that this schedule allows for maximizing the diffusive and osmotic gradients [ 43 ].…”

What is the Adequate DOSE for Peritoneal Dialysis in Acute Kidney Injury: Lower the Bar or Shift the Goalposts?

“…Certainly it has been shown in CKD patients that automated PD (APD), with its more rapid cycles than continuous ambulatory PD (CAPD), results in lower phosphate clearance in all but the high-transporter categories despite equivalent ultrafiltration (11). Tidal PD may theoretically overcome this issue as there is a relatively constant volume of fluid in contact with the peritoneal membrane throughout the 24-hour period; however, studies have produced conflicting results (12,13).…”