Nephrology Dialysis Transplantation, Vol 13, Issue 9 2335-2340, Copyright © 1998 by Oxford University Press
A Rodriguez, N Diz, L Cubillo, J Plana, M Riscos, R Delgado, C Herrera, E Ribes, F Molina, M Heras, A Gonzalez, C Canton, A Fernandez, E Laborda, M Zurita, F Giron and P Santana
Background: A prospective sequential study on
continuous ambulatory peritoneal dialysis (CAPD) and three techniques of
automated peritoneal dialysis (APD) was conducted to assess peritoneal
clearances, the influence of peritoneal permeability on nocturnal APD
clearances and the suitability of the peritoneal equilibration test (PET)
for predicting clearances on APD. Methods: After
performing a PET, a series of clinical, biochemical and dialysis adequacy
markers were evaluated after 2 months on CAPD, continuous cycling
peritoneal dialysis (CCPD) and tidal volume peritoneal dialysis (TPD) with
50% and 25% tidal volumes. Forty five patients participated and 33
completed the study. Results: Serum urea and
creatinine decreased significantly whereas haemoglobin and glucose
increased. Mean peritoneal urea clearance (1/week) was
55.40±8.76 on CAPD, 74.82±12.62 on CCPD,
69.20±14.63 on TPD (tidal 50%) and 66.89±13.23 on TPD
(tidal 25%); mean creatinine clearance (1/week/1.73
m2) was 42.80±9.95,
52.19±11.11, 51.31±13.3 and 49.17±11.83
respectively. Both clearances were significantly lower on CAPD than on APD
(<0.001). CCPD was the automated technique that provided the best
nocturnal urea clearance (P<0.01). Nocturnal creatinine clearance
did not show significant differences between CCPD and TPD (tidal 50%),
being better with both techniques than with TPD (tidal 25%). There were
statistically significant differences between nocturnal dialysate to plasma
(D/P) ratios and those corresponding to the nearest times in the PET. The
urea D/P ratio at 180 min and the creatinine D/P ratio at 240 min of the
PET were the parameters that better estimated nocturnal clearances on APD.
Conclusions: This study confirms that TPD does not
improve the results of CCPD. Significant differences between D/P ratios
during actual nocturnal cycles and PETs were observed. Key
words: automated peritoneal dialysis; CAPD; clearances; PET
ORIGINAL ARTICLES
Automated peritoneal dialysis: a Spanish multicentre study
Department of Nephrology, Hospital Nuestra Señora del Pino, Las Palmas, Gran Canaria, Spain; Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Virgen de Rocío, Sevilla, Spain; Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Virgen de la Luz, Cuenca, Spain; Hospital Virgen de la Candelaria, Tenerife, Spain; Hospital Insular, Las Palmas, Gran Canaria, Spain; Hospital Carlos Haya, Malaga, Spain; Hospital Juan Ramón Jiménez, Huela, Spain; Department of Mathematics, University of Las Palmas, Las Palmas, Gran Canaria, Spain; Corresponding author at: Servicio de Nefrología, Hospital Nuestra Señra del Pino, Angel Guimera 96, E-35004 Las Palmas de Gran Canaria, Spain
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