This study compares 5 different tidal automated peritoneal dialysis (APD) prescriptions. Six low-average and 6 high-average transporters performed 3 separate sessions with 5 different schedules: (A) 50% tidal with initial fill volume (FV) 2 liters, (B) 50% tidal with 2.2 liters initial FV, (C) 2.2 liters initial FV with 70% tidal, (D) as in B, with one complete renewal of the initial FV at midsession, (E) 2.2 liters FV with breakpoint modality. Urea, creatinine and phosphate peritoneal clearances, sodium removal and ultrafiltration (UF) were compared using analysis of variance. Compared to treatment A, all the tested alternative schedules were associated with 10% significantly higher urea clearance; B, D and E, but not C, were associated with 10% higher creatinine clearance. Phosphate clearance was significantly higher with D, while sodium removal was larger with both C and D. UF was lower with A and E in high average transporters. Manipulation of the main prescriptive parameters of tidal APD has significant impact on its efficiency.

Keywords:
Ultrafiltration, Urea, Tidal, Breakpoint, Creatinine, Dialysis efficiency, Peritoneal dialysis, Phosphate, Sodium removal, Solute clearance
1.
Jain AK, Blake P, Cordy P, Garg AX: Global trends in rates of peritoneal dialysis. J Am Soc Nephrol 2012;23:533-544.
2.
Liakopoulos V, Dombros N: Patient selection for automated peritoneal dialysis: for whom, when? Perit Dial Int 2009;29(suppl 2):S102-S107.
3.
Bieber SD, Burkart J, Golper TA, Teitelbaum I, Mehrotra R: Comparative outcomes between continuous ambulatory and automated peritoneal dialysis: a narrative review. Am J Kidney Dis 2014;63:1027-1037.
4.
Blake PG, Bargman JM, Brimble KS, Davison SN, Hirsch D, McCormick BB, et al: Clinical practice guidelines and recommendations on peritoneal dialysis adequacy 2011. Perit Dial Int 2011;31:218-239.
5.
Lo WK, Bargman JM, Burkart J, Krediet RT, Pollock C, Kawanishi H, et al: Guideline on targets for solute and fluid removal in adult patients on chronic peritoneal dialysis. Perit Dial Int 2006;26:520-522.
6.
Dombros N, Dratwa M, Feriani M, Gokal R, Heimbürger O, Krediet R, et al: European best practice guidelines for peritoneal dialysis: 7 adequacy of peritoneal dialysis. Nephrol Dial Transplant 2005;20(suppl 9):ix24-ix27.
7.
Cizman B, Lindo S, Bilionis B, Davis I, Brown A, Miller J, et al: The occurrence of increased intraperitoneal volume events in automated peritoneal dialysis in the US: role of programming, patient/user actions and ultrafiltration. Perit Dial Int 2014;34:434-442.
8.
Blake PG, Sloand JA, McMurray S, Jain AK, Matthews S: A multicenter survey of why and how tidal peritoneal dialysis (TPD) is being used. Perit Dial Int 2014;34:458-460.
9.
Kathuria P, Twardowski ZJ: Automated peritoneal dialysis; in Khanna R, Krediet RT, Nolph KD, Gokal R (eds): Textbook of Peritoneal Dialysis. Springer Science+Business Media, LLC, 2009, pp 303-334.
10.
Di Lauro V, Luccio F, Colaluca M, De Francesco F, Pintauro A: Intraperitoneal Hydrostatic pressure and volume in peritoneal dialysis patients. EDTNA ERCA J 1999;25:16-17.
11.
Virga G, Amici G, Mastrosimone S, Biasio G, Stanic L, Rin GD, et al: Day-to-day variability of adequacy indexes in peritoneal dialysis. Nephrol Dial Transplant 1999;14:2932-2936.
12.
Aasarød K, Widerøe TE, Flakne SC: A comparison of solute clearance and ultrafiltration volume in peritoneal dialysis with total or fractional (50%) intraperitoneal volume exchange with the same dialysate flow rate. Nephrol Dial Transplant 1997;12:2128-2132.
13.
Juergensen PH, Murphy AL, Pherson KA, Kliger AS, Finkelstein FO: Tidal peritoneal dialysis: comparison of different tidal regimens and automated peritoneal dialysis. Kidney Int 2000;57:2603-2607.
14.
Mujais S, Childers RW: Profiles of automated peritoneal dialysis prescriptions in the US 1997-2003. Kidney Int Suppl 2006;103:S84-S90.
15.
Rodriguez AM, Diaz NV, Cubillo LP, et al: Automated peritoneal dialysis: a Spanish multicentre study. Nephrol Dial Transplant 1998;13:2335-2340.
16.
Wychytil A, Hörl WH: The role of tidal peritoneal dialysis in modern practice: a European perspective. Kidney Int Suppl 2006;103:S96-S103.
17.
Edefonti A, Picca M, Consalvo G, et al: Prescription and assessment of tidal peritoneal dialysis delivery with a specific equilibration test. Perit Dial Int 1996;16:295-301.
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2016
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