AUTOMATED PERITONEAL-DIALYSIS, AN ADEQUAT E THERAPEUTIC OPTION IN TERMINAL RENAL-FAILURE - PRELIMINARY EXPERIENCES WITH A NEW PNEUMATIC CYCLER

Objective: To determine whether (1) the recently developed pneumatic c ycler for automatic peritoneal dialysis (APD) achieves individually ad justable adequate dialysis efficacy, and (2) changing from continuous ambulatory peritoneal dialysis (CAPD) to APD results in an appropriate increase of dialysis efficacy. Patients and methods: Between July 199 4 and August 1995 dialysis treatment for chronic renal failure was per formed in 17 patients (four women, 13 men: mean age 42.9 +/- 11.6 year s). Ten patients decided primarily on APD, seven changed over from CAP D to APD because of inadequate dialysis efficacy. Adequacy of dialysis was judged by clinical criteria, weekly creatinine clearances (wC(cr) ) and urea levels (urea elimination related to distribution volume [wK T/V]). Results: Mean treatment period with APD was 7.9 +/- 0.3 hours, dialysate volume 19.4 +/- 2.31. An ultrafiltration of 1253 +/- 643 ml was achieved. Mean serum creatinine was 13.1 +/- 3.5 mg/dl, mean serum urea-nitrogen 61 +/- 15 mg/dl. wC(cr) was 78.6 +/- 27.21, wKT/V 2.21 +/- 0.33. All patients were adequately dialysed with various forms of APD. In those patients who changed from CAPD the dialysis efficacy, ju dged by weekly urea-nitrogen elimination, increased by 50% from 1.42 /- 0.29 to 2.14 +/- 0.20 (P < 0.05). With the pneumatic cycler the dif ferent dialysis modes were achieved without problem. Conclusion: APD w ith the new pneumatic cycler provided an adequate and attractive optio n, from both medical and psychosocial aspects, in the dialysis of pati ents in chronic renal failure. Changing from CAPD to APD in certain pa tient groups clearly increased dialysis efficacy so that changing over to haemodialysis can often be avoided.