Determinants in APD selection

Abstract

Automated peritoneal dialysis (APD) is the most prevalent form of peritoneal dialysis in the United States. Optimizing the success of this treatment requires appropriate patient selection; however, there are few data available on which patients are most likely to benefit the most from this form of therapy. The key factors to evaluate when APD is being considered include patient preferences and lifestyle, patient age, solute transport characteristics, residual renal function (RRF), cost, dialysis adequacy targets, and the potential for complications of therapy. Patients who prefer home dialysis at night, children, those with high average or high peritoneal transport characteristics, and those with significant RRF are ideal candidates for APD. Because of the flexibility that is possible in prescribing this form of dialysis, APD can be successfully performed in individuals who do not meet this ideal profile, and it can be an excellent form of dialysis, particularly as part of an integrated care program for patients with end-stage renal disease (ESRD).