Peritoneal dialysis adequacy: A model to assess feasibility with various modalities

Díaz-Buxó, José A.; Gotch, Frank A.; Folden, Tom; Rosenblum, Shelden; Zazra, James J.; Lew, Nancy L.; Crawford, Terri L.; Youngblood, Brenda; Pesich, Angie; Lazarus, J. Michael

doi:10.1046/j.1523-1755.1999.00472.x

Cited by 28 publications

(27 citation statements)

References 21 publications

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“…It is of concern that in the absence of residual renal function (RRF), only a minority of PD patients are capable of reaching adequate levels of small molecule clearance, without the use of automated PD. 10 As a technique, PD allows slow continuous ultrafiltration, but less efficient solute removal. In contrast, HD allows highly efficient solute removal but at the expense of interdialytic fluid overload and precipitous ultrafiltration.…”

mentioning

confidence: 99%

Complementary use of peritoneal and hemodialysis: Therapeutic synergies in the treatment of end-stage renal failure patients

Kawanishi

McIntyre

2008

Kidney International

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The simultaneous use of peritoneal dialysis (PD) and hemodialysis therapy has been studied both in established PD patients who are experiencing problems with their dialysis treatment that might otherwise prompt a change in modality, and in patients new to dialysis. The application of combination therapy allows in incident patients a partial separation of solute clearance and ultrafiltration, optimizing each modality within that overall delivery. This article discusses the published experience of combination treatment, and considers the possible benefits of such an approach.

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confidence: 99%

Complementary use of peritoneal and hemodialysis: Therapeutic synergies in the treatment of end-stage renal failure patients

Kawanishi

McIntyre

2008

Kidney International

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“…CFPD might contribute to maintaining patients longer on PD without the need of transferring them to an extracorporeal technique when it becomes difficult to achieve adequacy targets (1,10,(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40). CFPD might represent a first-choice technique in some patients, especially when large-size or peritoneal hyperpermeable patients are involved.…”

Section: New Pd Techniquesmentioning

confidence: 99%

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

Dell’Aquila

Bordoni

D'Intini

et al. 2002

Seminars in Dialysis

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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.

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“…This study design is highly biased toward selecting patients with the largest V . In some instances the Kt / V would be low due to low transporters (few according to previous estimates of frequency), but in the great majority of patients selected, the Kt / V had to be low due to a high V , since Kt was constant (7). In hemodialysis, the sensitivity to dose is less in large V patients and the risk of mortality much lower (8).…”

Section: Optimal Clearancesmentioning

confidence: 99%

Automated Peritoneal Dialysis Symposium: The Future of APD

Díaz-Buxó

2002

Seminars in Dialysis

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The future of automated peritoneal dialysis (APD) greatly depends on its ability to provide optimal clearances and volume control, preserve peritoneal transport, maintain adequate peritoneal access, and offer flexibility of prescription at a reasonable and competitive cost. Each of these aspects are discussed in the light of recent technologic advances and clinical experiences in order to project a vision of the potential future of APD.

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Peritoneal dialysis adequacy: A model to assess feasibility with various modalities

Abstract: Most patients can attain the current adequacy standards of therapy with automated PD, but few (less than 25%) can do so with standard CAPD in the absence of residual renal function.

Cited by 28 publications

References 21 publications

Complementary use of peritoneal and hemodialysis: Therapeutic synergies in the treatment of end-stage renal failure patients

Complementary use of peritoneal and hemodialysis: Therapeutic synergies in the treatment of end-stage renal failure patients

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

Automated Peritoneal Dialysis Symposium: The Future of APD

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