PMID- 11887807
OWN - NLM
STAT- MEDLINE
DCOM- 20020823
LR  - 20200109
IS  - 0896-8608 (Print)
IS  - 0896-8608 (Linking)
VI  - 21 Suppl 3
DP  - 2001
TI  - Adequacy targets can be met in anuric patients by automated peritoneal dialysis: 
      baseline data from EAPOS.
PG  - S133-7
AB  - OBJECTIVE: Conventional continuous ambulatory peritoneal dialysis (CAPD) in 
      patients without residual renal function and with high solute transport is 
      associated with worse clinical outcomes. Automated peritoneal dialysis (APD) has 
      the potential to improve both solute clearance and ultrafiltration in these 
      circumstances, but its efficacy as a treatment modality is unknown. The European 
      Automated Peritoneal Dialysis Outcomes Study (EAPOS) is a 2-year, prospective, 
      European multicenter study designed to determine APD feasibility and clinical 
      outcomes in anuric patients. The present article describes the baseline data for 
      patients recruited into the study. DESIGN: All PD patients treated in the 
      participating centers were screened for inclusion criteria [urinary output < 100 
      mL/24 h, or residual renal function (RRF) < 1 mL/min, or both]. After enrollment, 
      changes were made to the dialysis prescription to achieve a weekly creatinine 
      clearance above 60 L per 1.73 m2 and an ultrafiltration rate above 750 mL in 24 
      hours. SETTING: The study is being conducted in 26 dialysis centers in 13 
      European countries. BASELINE DATA COLLECTION: The information collected includes 
      patient demographics, dialysis prescription, achieved weekly creatinine 
      clearance, and 24-hour ultrafiltration (UF). RESULTS: The study enrolled 177 
      anuric patients. Median dialysis duration before enrollment was 22.5 months 
      (range: 0-285 months). Mean solute transport measured as the dialysate-to-plasma 
      ratio of creatinine (D/P(Cr)) was 0.74 +/- 0.12. Patients received APD for a 
      median of 9.0 hours overnight (range: 7-12 hours) using a median of 11.0 L of 
      fluid (range: 6-28.75 L). Median daytime volume was 4.0 L (range: 0.0-9.0 L). 
      Tidal dialysis was used in 26 patients, and icodextrin in 86 patients. At 
      baseline, before treatment optimization, the weekly mean total creatinine 
      clearance was 65.2 +/- 14.4 L/1.73 m2, with 105 patients (60%) achieving the 
      target of more than 60 L/1.73 m2. At baseline, 81% of patients with high 
      transport, 69% with high-average transport, and 40% with low-average transport 
      met the target. At baseline, 70% of patients with a body surface area (BSA) below 
      1.7 m2, 60% with a BSA of 1.7-2.0 m2, and 56% with a BSA above 2.0 m2 achieved 60 
      L/1.73 m2 weekly. Median UF was 1090 mL/24 h, and 75% of patients achieved the UF 
      target of more than 750 mL/24 h. CONCLUSION: This baseline analysis of anuric 
      patients recruited into the EAPOS study demonstrates that a high proportion of 
      anuric patients on APD can achieve dialysis and ultrafiltration targets using a 
      variety of regimes. This 2-year follow-up study aims to optimize APD prescription 
      to reach predefined clearance and ultrafiltration targets, and to observe the 
      resulting clinical outcomes.
FAU - Brown, E A
AU  - Brown EA
AD  - Charing Cross Hospital, London, UK.
FAU - Davies, S J
AU  - Davies SJ
FAU - Heimburger, O
AU  - Heimburger O
FAU - Meeus, F
AU  - Meeus F
FAU - Mellotte, G
AU  - Mellotte G
FAU - Rosman, J
AU  - Rosman J
FAU - Rutherford, P
AU  - Rutherford P
FAU - Van Bree, M
AU  - Van Bree M
CN  - European Automated Peritoneal Dialysis Outcomes Study (EAPOS) Investigators
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Perit Dial Int
JT  - Peritoneal dialysis international : journal of the International Society for 
      Peritoneal Dialysis
JID - 8904033
RN  - 0 (Dialysis Solutions)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anuria/metabolism/*therapy
MH  - Biological Transport
MH  - Body Surface Area
MH  - Creatinine/metabolism
MH  - Dialysis Solutions/chemistry
MH  - Feasibility Studies
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Peritoneal Dialysis
MH  - Peritoneum/metabolism
MH  - Prospective Studies
MH  - Ultrafiltration
EDAT- 2002/03/13 10:00
MHDA- 2002/08/24 10:01
CRDT- 2002/03/13 10:00
PHST- 2002/03/13 10:00 [pubmed]
PHST- 2002/08/24 10:01 [medline]
PHST- 2002/03/13 10:00 [entrez]
PST - ppublish
SO  - Perit Dial Int. 2001;21 Suppl 3:S133-7.