title: A Brazilian experience in assisted automated peritoneal dialysis: a reliable and effective home care approach.
abstract: BACKGROUND
  Automated assisted peritoneal dialysis (AAPD) has been shown to be successful as renal replacement therapy for elderly and physically incapable end-stage renal disease (ESRD) patients. In early 2003, a pioneer AAPD program was initiated at GAMEN Renal Clinic in Rio de Janeiro, Brazil. ♢
  
  
  OBJECTIVE
  We evaluated the results of an AAPD program offered as an option to elderly ESRD patients with physical or cognitive debilities or as last resort to patients with vascular access failure or hemodynamic instability during hemodialysis. ♢
  
  
  METHODS
  A cohort of 30 consecutive patients started AAPD from January 2003 to March 2008 and was followed to July 2009. Demographics, clinical and laboratory parameters, causes of death, and patient and technique survival were analyzed. ♢
  
  
  RESULTS
  Median age of the patients was 72 years (range: 47 - 93 years), with 60% being older than 65. The Davies score was greater than 2 in 73% of patients, and the Karnofsky index was less than 70 in 40%. The overall peritonitis rate was 1 episode in 37 patient-months. The total duration of AAPD ranged from 3 to 72 months. Patient survival was 80% at 12 months, 60% at 24 months, and 23.3% at 48 months. The most common cause of death was cardiovascular problems (70%). ♢
  
  
  CONCLUSIONS
  In this clinical observational study, AAPD fulfilled its expected role, offering an opportune, reliable, and effective homecare alternative for ESRD patients with no other renal replacement therapy options.
authors: GAMEN Renal Clinic, Rio de Janeiro.
authors: Marcia Regina Gianotti
authors: MR
authors: Franco
authors: Natália
authors: N
authors: Fernandes
authors: Claúdia Azevedo
authors: CA
authors: Ribeiro
authors: Abdul Rashid
authors: AR
authors: Qureshi
authors: Jose Carolino
authors: JC
authors: Divino-Filho
authors: Maria
authors: M
authors: da Glória Lima
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D002423:Cause of Death; D015897:Comorbidity; D005260:Female; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000379:methods* / Q000592:standards; D010538:Peritonitis / Q000453:epidemiology; D016730:Program Development
keywords: Assisted automated peritoneal dialysis; Brazil; elderly patients
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