Abstract: PUB190
Influence of Variable Inflow Volume, Dwell Duration, and Dialysate Glucose Concentration on Ultrafiltration Volume in Patients on Automated Peritoneal Dialysis: pPD Study
Session Information
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- De los Ríos, Tatiana, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Hessen, Germany
- Garcia, Isabel, Hospital Universitario Son Espases, Palma, Illes Balears, Spain
- Schmitt, Jana, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Hessen, Germany
- Stauss-Grabo, Manuela, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Hessen, Germany
- Atiye, Saynab, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Hessen, Germany
Background
In current practice, optimization of peritoneal dialysis (PD) prescription relies heavily on clinical techniques and a trial-and-error process, as prescription must be tailored to achieve a number of outcome goals, given the peritoneal membrane transport characteristics of the patient. So far, developments in practice have made important contributions to the notion of precision PD (pPD). Given the many demands of a PD prescription, ultimately, pPD refers to the process of finding the optimal profile of PD treatment that fits the patient's lifestyle while maintaining homeostasis. The pPD study is designed to investigate the influence of ‘dialysis dose variables’ (dwell duration, glucose concentration, inflow volume) on ultrafiltration volume per defined dwells in automated peritoneal dialysis (APD) patients.
Methods
This is a prospective, multicenter, interventional pilot study. Ten patients with total weekly Kt/V ≥ 1.7 and treated with the sleep safe or sleep safe harmony PD-cycler (Fresenius Medical Care, Bad Homburg, Germany) will be included.
After a training phase and a run-in period of up to 6 weeks, depending on the PD cycler used prior to the study, the interventional phase will be initiated. The interventional phase has 3 subphases; in each of them, one of three ‘dialysis dose variables’ will be varied: dwell duration (phase A), glucose concentration (phase B), and inflow volume (phase C). This will be followed by a follow-up period of 4 weeks (see figure).
Results
Due to the small sample size, statistical analyses will comprise descriptive statistics and hypothesis testing using non-parametric tests where appropriate.
Conclusion
In this study, dose variables will be evaluated over a wide range, to become part of the clinical toolbox not only for delivering optimal treatment but as a method for peritoneal membrane function assessment. This study aims to collect additional diagnostic information while making repeated observations in the same patient during which the PD prescription undergoes systematic adaptations.
Funding
- Commercial Support – Fresenius Medical Care Deutschland GmbH