APD or CAPD: one glove does not fit all

The use of Automated Peritoneal Dialysis (APD) in its various forms has increased over the past few years mainly in developed countries. This could be attributed to improved cycler design, apparent lifestyle benefits and the ability to achieve adequacy and ultrafiltration targets. However, the dilem...

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Bibliographic Details
Published in:International urology and nephrology 2021-06, Vol.53 (6), p.1149-1160
Main Authors: Roumeliotis, Athanasios, Roumeliotis, Stefanos, Leivaditis, Konstantinos, Salmas, Marios, Eleftheriadis, Theodoros, Liakopoulos, Vassilios
Format: Article
Language:English
Subjects:
Medicine
Medicine & Public Health
Nephrology
Nephrology - Review
Peritoneal dialysis
Peritoneum
Peritonitis
Renal function
Sleep
Ultrafiltration
Urology
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Summary:The use of Automated Peritoneal Dialysis (APD) in its various forms has increased over the past few years mainly in developed countries. This could be attributed to improved cycler design, apparent lifestyle benefits and the ability to achieve adequacy and ultrafiltration targets. However, the dilemma of choosing the superior modality between APD and Continuous Ambulatory Peritoneal Dialysis (CAPD) has not yet been resolved. When it comes to fast transporters and assisted PD, APD is certainly considered the most suitable Peritoneal Dialysis (PD) modality. Improved patients’ compliance, lower intraperitoneal pressure and possibly lower incidence of peritonitis have been also associated with APD. However, concerns regarding increased cost, a more rapid decline in residual renal function, inadequate sodium removal and disturbed sleep are APD’s setbacks. Besides APD superiority over CAPD in fast transporters, the other medical advantages of APD still remain controversial. In any case, APD should be readily available for all patients starting PD and the most important indication for its implementation remains patient’s choice.
ISSN:0301-1623
1573-2584
DOI:10.1007/s11255-020-02678-6