Key result
Automated peritoneal dialysis was associated with a more rapid decline in residual renal function compared to continuous ambulatory peritoneal dialysis during the first year, though this was marginally significant after multivariate adjustment (β=-31.50, p=0.052).
Why the study?
Does automated peritoneal dialysis compared to continuous ambulatory peritoneal dialysis affect the 1-year rate of decline of residual renal function in incident peritoneal dialysis patients?
Cohort (n=142)
No
Does automated peritoneal dialysis compared to continuous ambulatory peritoneal dialysis affect the 1-year rate of decline of residual renal function in incident peritoneal dialysis patients?
Mean Difference: -31.5 (95% CI -63.61–0.62)
p-value: p=0.052
Continuous ambulatory peritoneal dialysis may be more effective than automated peritoneal dialysis for preserving residual renal function during the first year of therapy.
May favor continuous ambulatory peritoneal dialysis to slow residual renal function decline in year one; leaves open whether randomized trials confirm this association.
PURPOSE: The effect of different peritoneal dialysis (PD) modalities on the decline in residual renal function (RRF) is unclear due to inconsistencies among studies. In particular, the effect of automated peritoneal dialysis (APD) modalities [continuous cyclic peritoneal dialysis (CCPD) and nightly intermittent peritoneal dialysis (NIPD)] on RRF has not been examined in a large cohort. MATERIALS AND METHODS: We conducted a single-center retrospective study to investigate the association between PD modalities and decline in RRF in 142 incident PD patients [34 on CCPD, 36 on NIPD, and 72 on continuous ambulatory peritoneal dialysis (CAPD)]. RRF was measured within 2 months from PD start and at 1 year after PD initiation. RESULTS: The RRF at 1 year after PD initiation was 1.98±2.20 mL/min/1.73 m² in CCPD patients and 3.63±3.67 mL/min/1.73 m² in NIPD patients, which were moderately lower than 4.23±3.51 mL/min/1.73 m² in CAPD patients (p=0.064). Moreover, there was no significant difference in the 1-year rate of decline of RRF between CCPD and NIPD patients, although APD patients had a faster 1-year RRF decline rate than CAPD patients (CCPD and NIPD vs. CAPD: -45.68 and -36.69 vs. 1.17%/year, p=0.045). APD was associated with a more rapid decline in RRF in patients with end-stage renal disease undergoing PD, although multivariate analysis attenuated the significance of this finding (β=-31.50; 95% CI, -63.61 to 0.62; p=0.052). CONCLUSION: Our results suggest that CAPD might be more helpful than APD for preserving RRF during the first year of dialysis therapy, although there was no significant difference in the 1-year rate of decline of RRF between the two APD modalities.
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Kim et al. (2013) conducted a cohort in End-stage renal disease (n=142). Automated peritoneal dialysis (APD) vs. Continuous ambulatory peritoneal dialysis (CAPD) was evaluated on 1-year rate of decline of residual renal function (β=-31.50, 95% CI -63.61 to 0.62, p=0.052). Automated peritoneal dialysis was associated with a more rapid decline in residual renal function compared to continuous ambulatory peritoneal dialysis during the first year, though this was marginally significant after multivariate adjustment (β=-31.50, p=0.052).
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