Title:
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Current clinical practice in adapted automated peritoneal dialysis (aAPD)-A prospective, non-interventional study
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Author:
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Vera, Manel; Cheak, Bee Boon; Chmelíčková, Hana; Bavanandan, Sunita; Goh, Bak Leong; Abdul Gafor, Abdul Halim; García-Méndez, Isabel
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Other authors:
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Institut Català de la Salut; [Vera M] Nephrology, Hospital Clinic de Barcelona, Barcelona, Spain. [Cheak BB] Department of Nephrology, Hospital Selayang, Selangor, Malaysia. [Chmelíčková H] Nephrology, Hospital Trebic, Trebic, Czech Republic. [Bavanandan S] Nephrology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia. [Goh BL] Nephrology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia. [Abdul Gafor AH] Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia. [García I] Departament de Nefrologia, Hospital Universitari de Girona Doctor Josep Trueta, Institut Català de la Salut (ICS), Girona, Spain; Hospital Universitari de Girona Dr Josep Trueta |
Abstract:
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Insuficiència renal crònica; Diàlisi peritoneal |
Abstract:
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Fallo renal crónico; Diálisis peritoneal |
Abstract:
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Chronic Kidney Failure; Peritoneal Dialysis |
Abstract:
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Adapted automated peritoneal dialysis (aAPD), comprising a sequence of dwells with different durations and fill volumes, has been shown to enhance both ultrafiltration and solute clearance compared to standard peritoneal dialysis with constant time and volume dwells. The aim of this non-interventional study was to describe the different prescription patterns used in aAPD in clinical practice and to observe outcomes characterizing volume status, dialysis efficiency, and residual renal function over 1 year. Prevalent and incident, adult aAPD patients were recruited during routine clinic visits, and aAPD prescription, volume status, residual renal function and laboratory data were documented at baseline and every quarter thereafter for 1 year. Treatments were prescribed according to the nephrologist's medical judgement in accordance with each center's clinical routine. Of 180 recruited patients, 160 were analyzed. 27 different aAPD prescription patterns were identified. 79 patients (49.4%) received 2 small, short dwells followed by 3 long, large dwells. During follow-up, volume status changed only marginally, with visit mean values ranging between 1.59 (95% confidence interval: 1.19; 1.99) and 1.97 (1.33; 2.61) L. Urine output and creatinine clearance decreased significantly, accompanied by reductions in ultrafiltration and Kt/V. 25 patients (15.6%) received a renal transplant and 15 (9.4%) were changed to hemodialysis. Options for individualization offered by aAPD are actually used in practice for optimized treatment. Changes observed in renal function and dialysis efficiency measures reflect the natural course of chronic kidney disease. No safety events were observed during the study period. |
Abstract:
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The study has been funded by Fresenius Medical Care. The funder was involved in the design, analysis, decision to publish and preparation of the manuscript. |
Subject(s):
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-Insuficiència renal crònica -Diàlisi peritoneal -DISEASES::Male Urogenital Diseases::Urologic Diseases::Kidney Diseases::Renal Insufficiency::Renal Insufficiency, Chronic::Kidney Failure, Chronic -ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Renal Replacement Therapy::Renal Dialysis::Peritoneal Dialysis -ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics::Epidemiologic Studies::Cohort Studies::Prospective Studies -ENFERMEDADES::enfermedades urogenitales masculinas::enfermedades urológicas::enfermedades renales::insuficiencia renal::insuficiencia renal crónica::fallo renal crónico -TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::tratamiento de reemplazo renal::diálisis renal::diálisis peritoneal -TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::técnicas de investigación::métodos epidemiológicos::características de los estudios epidemiológicos::estudios epidemiológicos::estudios de cohortes::estudios prospectivos |
Rights:
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Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
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Document type:
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Article Article - Published version |
Published by:
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Public Library of Science
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