scholarly journals Difference in perception of advantages and disadvantages of automated peritoneal dialysis for patients undergoing peritoneal dialysis: a conjoint analysis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hisako Yoshida ◽  
Kazuhiko Tsuruya
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Conjoint Analysis ◽  
Low Frequency ◽  
Case Vignette ◽  
Automated Peritoneal Dialysis ◽  
Point Scale ◽  
Advantages And Disadvantages ◽  
Maintenance Dialysis

Abstract Background In Japan, only less than 3% of patients undergoing maintenance dialysis select peritoneal dialysis (PD) as the mode of renal replacement therapy. Half of patients undergoing PD use a cycler for automated PD (APD). However, it remains unclear what patients undergoing PD regard as the benefits of APD. The purpose of this study was to objectively clarify what patients undergoing PD regard as the advantages and disadvantages of APD. Methods We designed case simulations that varied according to 6 characteristics of PD, such as the adequacy of dialysis and frequency of bag exchange, and created 16 simulation cards for conjoint analysis. For each case vignette, the respondents were asked to indicate whether they would receive this modality of PD on a 5-point scale. Results Thirty-two patients undergoing PD were recruited for this study and completed conjoint analysis simulation questionnaires. The factor with the highest importance in evaluating the modality of PD was the frequency of bag exchange among all participants. When participants were divided into those undergoing APD and continuous ambulatory PD (CAPD), the factor was different between them; that is, the low frequency of bag exchange is regarded as an advantage of APD for patients undergoing APD, while the large-sized cycler device is regarded as a disadvantage of APD for those undergoing CAPD. Conclusions The perception of advantages and disadvantages of APD differed between patients undergoing APD and CAPD; the former focus on the frequency of bag exchange, whereas the latter focused the size of device.

Continuous Ambulatory Peritoneal Dialysis is Better than Automated Peritoneal Dialysis as First-Line Treatment in Renal Replacement Therapy

2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 153-157
Author(s):  
Philip Kam-Tao Li ◽  
Kwok Yi Chung ◽  
Kai Ming Chow
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Large Scale ◽  
Residual Renal Function ◽  
Health Care Economics ◽  
Automated Peritoneal Dialysis ◽  
First Line ◽  
Randomized Controlled Studies

This article examines the roles of continuous ambulatory peritoneal dialysis (CAPD) versus automated peritoneal dialysis (APD) as first-line renal replacement therapy. To date, no high-quality large-scale randomized controlled studies have compared CAPD with APD as first-line therapy. However, a discussion on this issue is important so that nephrologists can decide and patients can have a choice of modality on which to start dialysis, especially in the context of health care economics. We review the literature and present Hong Kong as the model of a “CAPD first” policy, an appealing, cost-effective approach for any country. An ideal renal replacement therapy should provide optimal survival, lowest possible risk for comorbidity, highest level of quality of life, and equally important, acceptable cost to society. When we consider this subject in the context that all patients should be started on one first-line modality, the data suggest that a “CAPD first” policy has all these advantages, with APD probably having the edge only with regard to patient preference. The present review highlights preservation of residual renal function, removal and balancing of sodium, incidence of peritonitis, peritoneal membrane transport status, patient rehabilitation, and financial issues in demonstrating that a “CAPD first” policy is the model that should be adopted.

The Role of Peritoneal Dialysis as the First-Line Renal Replacement Modality

2000 ◽  
Vol 20 (4) ◽  
pp. 375-383 ◽  
Author(s):  
W. Van Biesen ◽  
R. Vanholder ◽  
N. Lameire
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Residual Renal Function ◽  
Risk Of Infection ◽  
First Line ◽  
Advantages And Disadvantages ◽  
Complementary Nature ◽  
Technique Failure

Twenty years after its introduction, peritoneal dialysis (PD) is a well-established alternative to hemodialysis (HD) as a modality of renal replacement therapy. Much debate and research is apparent in the literature, comparing hemodialysis and PD as “opposite” modalities and trying to ascertain which modality should be more optimal. In our opinion, HD and PD are two distinct modalities, each with its own advantages and disadvantages. In addition, it is clear that for both HD and PD, rates of technique failure are high, causing patients to transfer between modalities. The question is thus not which modality is best, but rather, which flow-chart of modalities makes best use of the advantages of each modality, while avoiding its disadvantages. In this respect, HD and PD appear to be complementary modalities. The better preservation of residual renal function, lower risk of infection with hepatitis B and C, better outcome after transplantation, preservation of vascular access, and lower costs are arguments to promote PD as a good initial treatment. When PD-related problems arise (adequacy, ultrafiltration, peritonitis, patient burnout), a timely transfer to HD has to be planned. This editorial tries to review arguments supporting the complementary nature of both modalities, and especially the role of PD as the first-line renal replacement therapy.

Automated Peritoneal Dialysis: New Implications for Pharmacists

1997 ◽  
Vol 31 (6) ◽  
pp. 756-764 ◽  
Author(s):  
Donald F Brophy ◽  
Bruce A Mueller
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
English Language ◽  
Treatment Modalities ◽  
Pharmacokinetic Parameters ◽  
Pharmacokinetic Studies ◽  
Automated Peritoneal Dialysis ◽  
Drug Dosing ◽  
Medline Search

OBJECTIVE: To review the new automated peritoneal dialysis (APD) modalities that are available to patients with end-stage renal disease (ESRD), and to examine their potential pharmacokinetic and drug dosing consequences. DATA SOURCES: A MEDLINE search (from January 1966 to June 1996) of English-language literature pertaining to peritoneal dialysis was performed. Additional references were obtained by reviewing the references of pertinent articles identified through the search. Tertiary sources were also used. DATA EXTRACTION: Data regarding peritoneal dialysis techniques and pharmacokinetics were extracted from the literature. Data were evaluated according to the study design, population, results, and conclusions. DATA SYNTHESIS: ESRD is the result of progressive chronic renal insufficiency and requires renal replacement therapy. APD is the fastest growing renal replacement therapy by percentage in the US and provides dialysis exchanges via a machine while the patient sleeps, thereby improving patient convenience, peritoneal dialysis compliance rates, and decreasing peritonitis rates. Well-designed pharmacokinetic studies involving APD have not been conducted. Consequently, no formal drug dosing recommendations are available for APD, and pharmacists must rely on established dosing guidelines for continuous ambulatory peritoneal dialysis (CAPD) when recommending dosing regimens. This article describes the new APD treatment modalities available and the potential pharmacokinetic differences between CAPD and APD. CONCLUSIONS: Well-designed studies are needed to fully characterize the pharmacokinetic parameters of drugs in APD. Until then, pharmacists should recommend that intraperitoneally administered drugs be given during the longest peritoneal dialysate dwell of the day and that serum concentrations of drugs with narrow therapeutic indices be monitored closely.

scholarly journals Renal Replacement Therapy: Purifying Efficiency of Automated Peritoneal Dialysis in Diabetic versus Non-Diabetic Patients

2015 ◽  
Vol 4 (7) ◽  
pp. 1518-1535 ◽  
Author(s):  
Nicanor Vega-Diaz ◽  
Fayna Gonzalez-Cabrera ◽  
Silvia Marrero-Robayna ◽  
Raquel Santana-Estupiñan ◽  
Roberto Gallego-Samper ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Diabetic Patients ◽  
Automated Peritoneal Dialysis

Continuous Hemodiafiltration in Children

PEDIATRICS ◽  
1990 ◽  
Vol 85 (5) ◽  
pp. 819-823
Author(s):  
Nancy A. Bishof ◽  
Thomas R. Welch ◽  
C. Frederic Strife ◽  
Frederick C. Ryckman
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Effective Means ◽  
Tumor Lysis Syndrome ◽  
Intermittent Hemodialysis ◽  
Tumor Lysis ◽  
Continuous Arteriovenous Hemofiltration

Continuous arteriovenous hemofiltration is a form of renal replacement therapy whereby small molecular weight solutes and water are removed from the blood via convection, alleviating fluid overload and, to a degree, azotemia. It has been used in many adults and several children. However, in patients with multisystem organ dysfunction and acute renal failure, continuous arteriovenous hemofiltration alone may not be sufficient for control of azotemia; intermittent hemodialysis or peritoneal dialysis may be undesirable in such unstable patients. Recently, the technique of continuous arteriovenous hemodiafiltration has been used in many severely ill adults. We have used continuous arteriovenous hemodiafiltration in four patients at Children's Hospital Medical Center. Patient 1 suffered perinatal asphyxia and oliguria while on extracorporeal membrane oxygenation. Patients 2 and 4 both had Burkitt lymphoma and tumor lysis syndrome. Patient 3 had septic shock several months after a bone marrow transplant. All had acute renal failure and contraindications to hemodialysis or peritoneal dialysis. A blood pump was used in three of the four patients, while spontaneous arterial flow was adequate in one. Continuous arteriovenous hemodiafiltration was performed for varying lengths of time, from 11 hours to 7 days. No patient had worsening of cardiovascular status or required increased pressor support during continuous arteriovenous hemodiafiltration. The two survivors (patients 2 and 4) eventually recovered normal renal function. Continuous arteriovenous hemodiafiltration is a safe and effective means of renal replacement therapy in the critically ill child. It may be ideal for control of the metabolic and electrolyte abnormalities of the tumor lysis syndrome.

Peritoneal dialysis: The unique features by compartmental delivery of renal replacement therapy

2017 ◽  
Vol 108 ◽  
pp. 128-132 ◽  
Author(s):  
Tibor Fülöp ◽  
Lajos Zsom ◽  
Mihály B. Tapolyai ◽  
Miklos Z. Molnar ◽  
Sohail Abdul Salim ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy

scholarly journals Erythrocyte Sedimentation Rate in Patients with Renal Insufficiency and Renal Replacement Therapy

2021 ◽  
Author(s):  
Anna Buckenmayer ◽  
Lotte Dahmen ◽  
Joachim Hoyer ◽  
Sahana Kamalanabhaiah ◽  
Christian S. Haas
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Renal Insufficiency ◽  
Replacement Therapy ◽  
Sedimentation Rate ◽  
Inflammatory Markers ◽  
Erythrocyte Sedimentation ◽  
Esrd Patients

Abstract Background: The erythrocyte sedimentation rate (ESR) is a simple laboratory diagnostic tool for estimating systemic inflammation. It remains unclear, if renal function affects ESR, thereby compromising its validity. This pilot study aims to compare prevalence and extent of ESR elevations in hospitalized patients with or without kidney disease. In addition, the impact of renal replacement therapy (RRT) modality on ESR was determined.Methods: In this single-center, retrospective study, patients were screened for ESR values. ESR was compared in patients with and without renal disease and/or RRT. In addition, ESR was correlated with other inflammatory markers, the extent of renal insufficiency and clinical characteristics.Results: A total of 203 patients was identified, showing an overall elevated ESR in the study population (mean 51.7±34.6 mm/h). ESR was significantly increased in all patients with severe infection, active vasculitis or cancer, respectively, independent from renal function. Interestingly, there was no difference in ESR between patients with and without kidney disease or those having received a prior renal transplant or being on hemodialysis. However, ESRD patients treated with peritoneal dialysis presented with a significantly higher ESR (78.3±33.1 mm/h, p<0.001), while correlation with other inflammatory markers was not persuasive.Conclusions: We showed that ESR: (1) does not differ between various stages of renal insufficiency; (2) may be helpful as a screening tool also in patients with renal insufficiency; and (3) is significantly increased in ESRD patients on peritoneal dialysis per se, while it seems not to be affected by hemodialysis or renal transplantation (see graphical abstract as supplementary material).

Nierenersatzverfahren: Information, Aufklärung, Dokumentation

2018 ◽  
Vol 143 (12) ◽  
pp. 863-870
Author(s):  
Jan Galle ◽  
Jana Reitlinger
Keyword(s):  
Peritoneal Dialysis ◽  
Kidney Transplantation ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Kidney Donation ◽  
Living Donation ◽  
Short Term ◽  
Donor Kidney ◽  
Kidney Replacement Therapy ◽  
Caring Environment

AbstractIn renal replacement therapy, different methods are available: hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation (KTx). In addition, variants can be used: HD as a home HD or center HD, PD as a conventional PD or automated (cycler) PD, KTx as a potentially short-term predictable living donation or conventional donor kidney donation. The patient and his familiar or caring environment must be informed accordingly. This means first of all: information about which procedures of kidney replacement therapy are possible and can be offered. Then the specific risks associated with each procedure should be elucidated (e. g. HD and shunt bleeding, PD and peritonitis, KTx and infections/neoplasias). This necessarily includes a structured documentation of the educating center/doctor about the communicated information and decisions taken.

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