title: Comparative outcomes between continuous ambulatory and automated peritoneal dialysis: a narrative review.
abstract: Automated methods for delivering peritoneal dialysis (PD) to persons with end-stage renal disease continue to gain popularity worldwide, particularly in developed countries. However, the endeavor to automate the PD process has not been advanced on the strength of high-level evidence for superiority of automated over manual methods. This article summarizes available studies that have shed light on the evidence that compares the association of treatment with continuous ambulatory PD or automated PD (APD) with clinically meaningful outcomes. Published evidence, primarily from observational studies, has been unable to demonstrate a consistent difference in residual kidney function loss rate, peritonitis rate, maintenance of euvolemia, technique survival, mortality, or health-related quality of life in individuals undergoing continuous ambulatory PD versus APD. At the same time, the future of APD technology appears ripe for further improvement, such as the incorporation of voice commands and expanded use of telemedicine. Given these considerations, it appears that patient choice should drive the decision about PD modality.
authors.affiliation: University of Washington, Seattle, WA. Electronic address: scbieber@u.washington.edu.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Bieber
authors.affiliation: Wake Forest University, Winston-Salem, NC.
authors.forename: John
authors.initials: J
authors.lastname: Burkart
authors.affiliation: Vanderbilt University, Nashville, TN.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Golper
authors.affiliation: University of Colorado, Denver, CO.
authors.forename: Isaac
authors.initials: I
authors.lastname: Teitelbaum
authors.affiliation: University of Washington, Seattle, WA.
authors.forename: Rajnish
authors.initials: R
authors.lastname: Mehrotra
mesh_terms: D004867:Equipment Design; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D010538:Peritonitis / Q000209:etiology; D011788:Quality of Life; D017216:Telemedicine; D016896:Treatment Outcome
keywords: End-stage renal disease (ESRD); automated peritoneal dialysis (APD); continuous ambulatory peritoneal dialysis (CAPD); health-related quality of life; mortality; peritoneal dialysis (PD); peritonitis; residual kidney function