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Evidence summaries

Continuous Ambulatory Peritoneal Dialysis Versus Automated Peritoneal Dialysis for End-Stage Renal Disease

There appears to be no difference between continuous ambulatory peritoneal dialysis and automated peritoneal dialysis for clinically important outcomes in end-stage renal disease. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 3 studies with a total of 139 subjects. Automated peritoneal dialysis (ADP) did not differ from continuous ambulatory peritoneal dialysis 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.

Comment: The quality of evidence is downgraded by imprecise results; limited study size for each comparison.

    References

    • Rabindranath KS, Adams J, Ali TZ, MacLeod AM, Vale L, Cody J, Wallace SA, Daly C. Continuous ambulatory peritoneal dialysis versus automated peritoneal dialysis for end-stage renal disease. Cochrane Database Syst Rev 2007;(2):CD006515. [PubMed]

Primary/Secondary Keywords