title: Time course of peritoneal function in automated and continuous peritoneal dialysis.
abstract: OBJECTIVE
  In automated peritoneal dialysis (APD), a patient's peritoneal membrane is more intensively exposed to fresh dialysate than it is in continuous ambulatory peritoneal dialysis (CAPD). Our aim was to study, in incident peritoneal dialysis (PD) patients, the influence of APD-compared with that of CAPD-on peritoneal transport over 4 years.
  
  
  METHODS
  Patients were included if at least 2 annual standard permeability analyses (SPAs) performed with 3.86% glucose were available while the patient was using the same modality with which they had started PD (APD or CAPD). Patients were followed until their first modality switch. Differences in the pattern of SPA outcomes over time were tested using repeated-measures models adjusted for age, sex, comorbidity, primary kidney disease, and year of PD start.
  
  
  RESULTS
  The 59 CAPD patients enrolled were older than the 47 APD patients enrolled (mean age: 58 ± 14 years vs 49 ± 14 years; p < 0.01), and they had started PD earlier (mean start year: 2000 vs 2002). Over time, no differences in solute (p > 0.19) or fluid transport (p > 0.13) were observed. Similarly, free water transport (p = 0.43) and small-pore transport (p = 0.31) were not different between the modalities. Over time, patients on APD showed a faster decline in effective lymphatic absorption rate (ELAR: p = 0.02) and in transcapillary ultrafiltration (TCUF: p = 0.07, adjusted p = 0.05). Further adjustment did not change the results.
  
  
  CONCLUSIONS
  Compared with patients starting on CAPD, those starting on APD experienced a faster decline in ELAR and TCUF. Other transport parameters were not different over time between the groups.
authors.affiliation: Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands. w.m.michels@amc.uva.nl
authors.forename: Wieneke M
authors.initials: WM
authors.lastname: Michels
authors.forename: Marion
authors.initials: M
authors.lastname: Verduijn
authors.forename: Alena
authors.initials: A
authors.lastname: Parikova
authors.forename: Elisabeth W
authors.initials: EW
authors.lastname: Boeschoten
authors.forename: Dirk G
authors.initials: DG
authors.lastname: Struijk
authors.forename: Friedo W
authors.initials: FW
authors.lastname: Dekker
authors.forename: Raymond T
authors.initials: RT
authors.lastname: Krediet
mesh_terms: D000328:Adult; D000368:Aged; D015314:Dialysis Solutions / Q000737:chemistry; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000379:methods*; D010531:Peritoneal Dialysis, Continuous Ambulatory; D010537:Peritoneum / Q000378:metabolism*; D014462:Ultrafiltration
chemical_list: D015314:Dialysis Solutions