These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Incremental dialysis with automated peritoneal dialysis.
    Author: Neri L, Viglino G, Cappelletti A, Gandolfo C, Barbieri S.
    Journal: Adv Perit Dial; 2003; 19():93-6. PubMed ID: 14763041.
    Abstract:
    Since December 2000, we have proposed incremental dialysis to our patients with a glomerular filtration rate (GFR) of 8-9 mL/min/1.73 m2. The incremental dialysis uses automated peritoneal dialysis (APD) 3-4 days per week ["low frequency APD" (LF-APD)], with or without a full abdomen during the period between the nighttime sessions. From December 1, 2000, to September 30, 2001, LF-APD was selected by 5 patients (2 men, 3 women). Of the 5 patients, 4 worked (age: 53 +/- 12 years; range: 40-69 years), and 1 (age: 78 years) needed assistance from a partner who was available only on certain days of the week. Only 1 patient had diabetic nephropathy. The LF-APD was performed by 4 patients on alternate days ("standard LF-APD"), and by 1 patient 3 times per week (owing to limited availability of the partner). At the beginning of treatment, mean nightly LF-APD was 8.9 +/- 0.9 hours with a volume of 13.4 +/- 3.1 L. In 3 patients, icodextrin was used for the dwell between subsequent APD sessions (1-1.5 L). The other 2 patients kept an empty abdomen (owing to body image). Residual renal function (RRF) was measured every 3 months; adequacy and peritoneal equilibration test (PET), every 6 months. Total nightly APD volume was modified based on the results of the PET. At December 31, 2002, 3 patients with follow-ups of 25, 22, and 15 months were still on LF-APD because their GFR had remained unchanged. In another patient, the frequency of the APD sessions was increased after 5 months to 5 times per week from 3.5 times per week following a clinical assessment of underdialysis; however, that patient had had no significant change in GFR. Following a rapid decline in the diabetic patient's GFR (to 3.6 mL/min/1.73 m2 from 7.9 mL/min/1.73 m2 in 18 months) and refusal by that patient to increase the number of days of APD, the diabetic patient was transferred to hemodialysis. No episodes of peritonitis occurred in a total LF-APD follow-up of 84 patient-months. Compliance, assessed using the HomeChoice Pro system and comparing prescribed and recorded sessions, was total (no missed treatments). In conclusion, LF-APD can be a valid form of incremental dialysis and can help patients to choose PD as their first renal replacement therapy.
    [Abstract] [Full Text] [Related] [New Search]