Continuous ambulatory peritoneal dialysis versus automated peritoneal dialysis for end-stage renal disease

Kannaiyan S. Rabindranath, James Adams, Tariq Zulfiqar Ali, Alison Murray MacLeod, Luke David Vale, Dorothy June Cody, Sheila Ann Wallace, Conal Daly

Research output: Contribution to journalLiterature review

33 Citations (Scopus)

Abstract

Background: Peritoneal dialysis (PD) can be performed either manually as in continuous ambulatory peritoneal dialysis (CAPD) or using mechanical devices as in automated PD (APD). APD has been considered to have several advantages over CAPD such as reduced incidence of peritonitis, mechanical complications and greater psychosocial acceptability.

Objectives: To assess the comparative efficacy of CAPD and APD in patients who are dialysed for end-stage renal disease (ESRD).

Search strategy: We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Renal Group's specialised register and CINAHL. Authors of included studies were contacted, reference lists of identified RCTs and relevant narrative reviews were screened. Date of most recent search: May 2006 Selection criteria: RCTs comparing CAPD with APD in patients with ESRD.

Data collection and analysis: Data were abstracted independently by two authors onto a standard form. Relative risk (RR) for dichotomous data and a mean difference (MD) for continuous data were calculated with 95% confidence intervals (CI).

Main results: Three trials (139 patients) were included. APD did not differ from CAPD with respect to mortality (RR 1.49, 95% CI 0.51 to 4.37), risk of peritonitis (RR 0.75, 95% CI 0.50 to 1.11), switching from original PD modality to a different dialysis modality (RR 0.50, 95% CI 0.25 to 1.02), hernias (RR 1.26, 95% interval 0.32 to 5.01), PD fluid leaks (RR 1.06, 95% CI 0.11 to 9.83), PD catheter removal (RR 0.64, 95% CI 0.27 to 1.48) or hospital admissions (RR 0.96, 95% CI 0.43 to 2.17). There was no difference between either PD modality with respect to residual renal function (MD -0.17, 95% CI -1.66 to 1.32). One study found that peritonitis rates and hospitalisation were significantly less in patients on APD when results were expressed as episodes/patient-year. Another study found that patients on APD had significantly more time for work, family and social activities.

Authors' conclusions: APD has not been shown to have significant advantages over CAPD in terms of important clinical outcomes. APD may however be considered advantageous in select group of patients such as in the younger PD population and those in employment or education due to its psychosocial advantages. There is a need for a RCT comparing CAPD with APD with sufficiently large patient numbers looking at important clinical outcomes including residual renal function, accompanied by an economic evaluation to clarify the relative clinical and cost-effectiveness of both modalities.

Original languageEnglish
Article numberCD006515
Number of pages30
JournalCochrane Database of Systematic Reviews
Issue number2
DOIs
Publication statusPublished - 2007

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Continuous Ambulatory Peritoneal Dialysis
Peritoneal Dialysis
Chronic Kidney Failure
Confidence Intervals
Peritonitis
Kidney
Cost-Benefit Analysis
Ascitic Fluid
Hernia
MEDLINE
Patient Selection
Dialysis
Hospitalization
Catheters
Education
Equipment and Supplies
Mortality
Incidence

Keywords

  • humans
  • kidney failure, chronic
  • peritoneal dialysis
  • peritoneal dialysis, continuous ambulatory
  • randomized controlled trials as topic

Cite this

Rabindranath, K. S., Adams, J., Ali, T. Z., MacLeod, A. M., Vale, L. D., Cody, D. J., ... Daly, C. (2007). Continuous ambulatory peritoneal dialysis versus automated peritoneal dialysis for end-stage renal disease. Cochrane Database of Systematic Reviews, (2), [CD006515]. https://doi.org/10.1002/14651858.CD006515

Continuous ambulatory peritoneal dialysis versus automated peritoneal dialysis for end-stage renal disease. / Rabindranath, Kannaiyan S.; Adams, James; Ali, Tariq Zulfiqar; MacLeod, Alison Murray; Vale, Luke David; Cody, Dorothy June; Wallace, Sheila Ann; Daly, Conal.

In: Cochrane Database of Systematic Reviews, No. 2, CD006515, 2007.

Research output: Contribution to journalLiterature review

Rabindranath, Kannaiyan S. ; Adams, James ; Ali, Tariq Zulfiqar ; MacLeod, Alison Murray ; Vale, Luke David ; Cody, Dorothy June ; Wallace, Sheila Ann ; Daly, Conal. / Continuous ambulatory peritoneal dialysis versus automated peritoneal dialysis for end-stage renal disease. In: Cochrane Database of Systematic Reviews. 2007 ; No. 2.
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title = "Continuous ambulatory peritoneal dialysis versus automated peritoneal dialysis for end-stage renal disease",
abstract = "Background: Peritoneal dialysis (PD) can be performed either manually as in continuous ambulatory peritoneal dialysis (CAPD) or using mechanical devices as in automated PD (APD). APD has been considered to have several advantages over CAPD such as reduced incidence of peritonitis, mechanical complications and greater psychosocial acceptability.Objectives: To assess the comparative efficacy of CAPD and APD in patients who are dialysed for end-stage renal disease (ESRD).Search strategy: We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Renal Group's specialised register and CINAHL. Authors of included studies were contacted, reference lists of identified RCTs and relevant narrative reviews were screened. Date of most recent search: May 2006 Selection criteria: RCTs comparing CAPD with APD in patients with ESRD.Data collection and analysis: Data were abstracted independently by two authors onto a standard form. Relative risk (RR) for dichotomous data and a mean difference (MD) for continuous data were calculated with 95{\%} confidence intervals (CI).Main results: Three trials (139 patients) were included. APD did not differ from CAPD with respect to mortality (RR 1.49, 95{\%} CI 0.51 to 4.37), risk of peritonitis (RR 0.75, 95{\%} CI 0.50 to 1.11), switching from original PD modality to a different dialysis modality (RR 0.50, 95{\%} CI 0.25 to 1.02), hernias (RR 1.26, 95{\%} interval 0.32 to 5.01), PD fluid leaks (RR 1.06, 95{\%} CI 0.11 to 9.83), PD catheter removal (RR 0.64, 95{\%} CI 0.27 to 1.48) or hospital admissions (RR 0.96, 95{\%} CI 0.43 to 2.17). There was no difference between either PD modality with respect to residual renal function (MD -0.17, 95{\%} CI -1.66 to 1.32). One study found that peritonitis rates and hospitalisation were significantly less in patients on APD when results were expressed as episodes/patient-year. Another study found that patients on APD had significantly more time for work, family and social activities.Authors' conclusions: APD has not been shown to have significant advantages over CAPD in terms of important clinical outcomes. APD may however be considered advantageous in select group of patients such as in the younger PD population and those in employment or education due to its psychosocial advantages. There is a need for a RCT comparing CAPD with APD with sufficiently large patient numbers looking at important clinical outcomes including residual renal function, accompanied by an economic evaluation to clarify the relative clinical and cost-effectiveness of both modalities.",
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author = "Rabindranath, {Kannaiyan S.} and James Adams and Ali, {Tariq Zulfiqar} and MacLeod, {Alison Murray} and Vale, {Luke David} and Cody, {Dorothy June} and Wallace, {Sheila Ann} and Conal Daly",
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T1 - Continuous ambulatory peritoneal dialysis versus automated peritoneal dialysis for end-stage renal disease

AU - Rabindranath, Kannaiyan S.

AU - Adams, James

AU - Ali, Tariq Zulfiqar

AU - MacLeod, Alison Murray

AU - Vale, Luke David

AU - Cody, Dorothy June

AU - Wallace, Sheila Ann

AU - Daly, Conal

PY - 2007

Y1 - 2007

N2 - Background: Peritoneal dialysis (PD) can be performed either manually as in continuous ambulatory peritoneal dialysis (CAPD) or using mechanical devices as in automated PD (APD). APD has been considered to have several advantages over CAPD such as reduced incidence of peritonitis, mechanical complications and greater psychosocial acceptability.Objectives: To assess the comparative efficacy of CAPD and APD in patients who are dialysed for end-stage renal disease (ESRD).Search strategy: We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Renal Group's specialised register and CINAHL. Authors of included studies were contacted, reference lists of identified RCTs and relevant narrative reviews were screened. Date of most recent search: May 2006 Selection criteria: RCTs comparing CAPD with APD in patients with ESRD.Data collection and analysis: Data were abstracted independently by two authors onto a standard form. Relative risk (RR) for dichotomous data and a mean difference (MD) for continuous data were calculated with 95% confidence intervals (CI).Main results: Three trials (139 patients) were included. APD did not differ from CAPD with respect to mortality (RR 1.49, 95% CI 0.51 to 4.37), risk of peritonitis (RR 0.75, 95% CI 0.50 to 1.11), switching from original PD modality to a different dialysis modality (RR 0.50, 95% CI 0.25 to 1.02), hernias (RR 1.26, 95% interval 0.32 to 5.01), PD fluid leaks (RR 1.06, 95% CI 0.11 to 9.83), PD catheter removal (RR 0.64, 95% CI 0.27 to 1.48) or hospital admissions (RR 0.96, 95% CI 0.43 to 2.17). There was no difference between either PD modality with respect to residual renal function (MD -0.17, 95% CI -1.66 to 1.32). One study found that peritonitis rates and hospitalisation were significantly less in patients on APD when results were expressed as episodes/patient-year. Another study found that patients on APD had significantly more time for work, family and social activities.Authors' conclusions: APD has not been shown to have significant advantages over CAPD in terms of important clinical outcomes. APD may however be considered advantageous in select group of patients such as in the younger PD population and those in employment or education due to its psychosocial advantages. There is a need for a RCT comparing CAPD with APD with sufficiently large patient numbers looking at important clinical outcomes including residual renal function, accompanied by an economic evaluation to clarify the relative clinical and cost-effectiveness of both modalities.

AB - Background: Peritoneal dialysis (PD) can be performed either manually as in continuous ambulatory peritoneal dialysis (CAPD) or using mechanical devices as in automated PD (APD). APD has been considered to have several advantages over CAPD such as reduced incidence of peritonitis, mechanical complications and greater psychosocial acceptability.Objectives: To assess the comparative efficacy of CAPD and APD in patients who are dialysed for end-stage renal disease (ESRD).Search strategy: We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Renal Group's specialised register and CINAHL. Authors of included studies were contacted, reference lists of identified RCTs and relevant narrative reviews were screened. Date of most recent search: May 2006 Selection criteria: RCTs comparing CAPD with APD in patients with ESRD.Data collection and analysis: Data were abstracted independently by two authors onto a standard form. Relative risk (RR) for dichotomous data and a mean difference (MD) for continuous data were calculated with 95% confidence intervals (CI).Main results: Three trials (139 patients) were included. APD did not differ from CAPD with respect to mortality (RR 1.49, 95% CI 0.51 to 4.37), risk of peritonitis (RR 0.75, 95% CI 0.50 to 1.11), switching from original PD modality to a different dialysis modality (RR 0.50, 95% CI 0.25 to 1.02), hernias (RR 1.26, 95% interval 0.32 to 5.01), PD fluid leaks (RR 1.06, 95% CI 0.11 to 9.83), PD catheter removal (RR 0.64, 95% CI 0.27 to 1.48) or hospital admissions (RR 0.96, 95% CI 0.43 to 2.17). There was no difference between either PD modality with respect to residual renal function (MD -0.17, 95% CI -1.66 to 1.32). One study found that peritonitis rates and hospitalisation were significantly less in patients on APD when results were expressed as episodes/patient-year. Another study found that patients on APD had significantly more time for work, family and social activities.Authors' conclusions: APD has not been shown to have significant advantages over CAPD in terms of important clinical outcomes. APD may however be considered advantageous in select group of patients such as in the younger PD population and those in employment or education due to its psychosocial advantages. There is a need for a RCT comparing CAPD with APD with sufficiently large patient numbers looking at important clinical outcomes including residual renal function, accompanied by an economic evaluation to clarify the relative clinical and cost-effectiveness of both modalities.

KW - humans

KW - kidney failure, chronic

KW - peritoneal dialysis

KW - peritoneal dialysis, continuous ambulatory

KW - randomized controlled trials as topic

U2 - 10.1002/14651858.CD006515

DO - 10.1002/14651858.CD006515

M3 - Literature review

JO - Cochrane Database of Systematic Reviews

JF - Cochrane Database of Systematic Reviews

SN - 1469-493X

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ER -