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Comparing automated peritoneal dialysis with continuous ambulatory peritoneal dialysis: survival and quality of life differences?
Nephrol Dial Transplant. 2011 May; 26(5):1702-8.ND

Abstract

BACKGROUND

There is a wide disparity in the use of automated peritoneal dialysis (APD) or continuous ambulatory peritoneal dialysis (CAPD) in the UK. This may be due to a perceived quality of life and technique survival advantage with APD, although evidence is lacking.

METHODS

We conducted a single-centre retrospective study of incident end-stage renal disease initiating APD and CAPD with data collected prospectively over 5 years. PD modality was based on patient preference. Health status was assessed using SF-36 questionnaires at initial and 1-year follow-up appointments.

RESULTS

Three hundred and seventy-two patients were included: 194 patients chose APD, and 178 patients chose CAPD. CAPD patients were generally older and more dependent than APD patients. Univariate analysis for technique survival was inferior for CAPD (relative risk for failure 1.46, 95% CI 1.08-1.97). But on multivariate analysis when comorbidity was added into the model, PD modality was no longer a significant predictor of technique survival. There was no difference in decline in residual renal function. Baseline CAPD patients had worse health status (HS); mean (SEM) physical and social composite scores were 32.3 (0.9) vs 36.5 (0.9) and 33.3 (1.2) vs 40.3 (1.2). After 1 year, HS scores for CAPD and APD patients were similar, but the improvement in HS scores correlated with baseline scores (PD modality was not an independent predictor of the change in HS).

CONCLUSIONS

This study did not show any advantages of APD over CAPD in terms of technique survival or HS. There is no evidence to support physician bias towards one PD modality, and both should be available to allow patient choice.

Authors+Show Affiliations

Department of Renal Medicine and Transplantation, The Royal London and St Bartholomew’s Hospitals, London, UK. s.fan@qmul.ac.ukNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

20921296

Citation

Balasubramanian, Gowrie, et al. "Comparing Automated Peritoneal Dialysis With Continuous Ambulatory Peritoneal Dialysis: Survival and Quality of Life Differences?" Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 26, no. 5, 2011, pp. 1702-8.
Balasubramanian G, McKitty K, Fan SL. Comparing automated peritoneal dialysis with continuous ambulatory peritoneal dialysis: survival and quality of life differences? Nephrol Dial Transplant. 2011;26(5):1702-8.
Balasubramanian, G., McKitty, K., & Fan, S. L. (2011). Comparing automated peritoneal dialysis with continuous ambulatory peritoneal dialysis: survival and quality of life differences? Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 26(5), 1702-8. https://doi.org/10.1093/ndt/gfq607
Balasubramanian G, McKitty K, Fan SL. Comparing Automated Peritoneal Dialysis With Continuous Ambulatory Peritoneal Dialysis: Survival and Quality of Life Differences. Nephrol Dial Transplant. 2011;26(5):1702-8. PubMed PMID: 20921296.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparing automated peritoneal dialysis with continuous ambulatory peritoneal dialysis: survival and quality of life differences? AU - Balasubramanian,Gowrie, AU - McKitty,Khadija, AU - Fan,Stanley L-S, Y1 - 2010/10/04/ PY - 2010/10/6/entrez PY - 2010/10/6/pubmed PY - 2011/9/29/medline SP - 1702 EP - 8 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol. Dial. Transplant. VL - 26 IS - 5 N2 - BACKGROUND: There is a wide disparity in the use of automated peritoneal dialysis (APD) or continuous ambulatory peritoneal dialysis (CAPD) in the UK. This may be due to a perceived quality of life and technique survival advantage with APD, although evidence is lacking. METHODS: We conducted a single-centre retrospective study of incident end-stage renal disease initiating APD and CAPD with data collected prospectively over 5 years. PD modality was based on patient preference. Health status was assessed using SF-36 questionnaires at initial and 1-year follow-up appointments. RESULTS: Three hundred and seventy-two patients were included: 194 patients chose APD, and 178 patients chose CAPD. CAPD patients were generally older and more dependent than APD patients. Univariate analysis for technique survival was inferior for CAPD (relative risk for failure 1.46, 95% CI 1.08-1.97). But on multivariate analysis when comorbidity was added into the model, PD modality was no longer a significant predictor of technique survival. There was no difference in decline in residual renal function. Baseline CAPD patients had worse health status (HS); mean (SEM) physical and social composite scores were 32.3 (0.9) vs 36.5 (0.9) and 33.3 (1.2) vs 40.3 (1.2). After 1 year, HS scores for CAPD and APD patients were similar, but the improvement in HS scores correlated with baseline scores (PD modality was not an independent predictor of the change in HS). CONCLUSIONS: This study did not show any advantages of APD over CAPD in terms of technique survival or HS. There is no evidence to support physician bias towards one PD modality, and both should be available to allow patient choice. SN - 1460-2385 UR - https://www.unboundmedicine.com/medline/citation/20921296/Comparing_automated_peritoneal_dialysis_with_continuous_ambulatory_peritoneal_dialysis:_survival_and_quality_of_life_differences L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfq607 DB - PRIME DP - Unbound Medicine ER -