PMID- 16722025
OWN - NLM
STAT- MEDLINE
DCOM- 20061005
LR  - 20200109
IS  - 0896-8608 (Print)
IS  - 0896-8608 (Linking)
VI  - 26
IP  - 3
DP  - 2006 May-Jun
TI  - Automated peritoneal dialysis has significant effects on systemic hemodynamics.
PG  - 328-35
AB  - OBJECTIVES: Maintenance of residual renal function (RRF) is an important 
      determinant of outcome in peritoneal dialysis patients. It remains contentious as 
      to whether automated peritoneal dialysis (APD) leads to an increased rate of 
      decline of RRF compared with continuous ambulatory peritoneal dialysis (CAPD). We 
      studied whether APD was associated with significant systemic hemodynamic changes 
      that may play a role in the accelerated loss of RRF. METHODS: As a follow-on from 
      a previous study, 8 well-established CAPD patients underwent a 4-hour APD 
      treatment consisting of 3 drain/fill cycles using 2 x 2.5 L 1.36% glucose and 1 x 
      3.86% glucose dialysate. Each dwell phase lasted 76 minutes. Blood pressure (BP) 
      and a full range of hemodynamic variables, including pulse (HR), stroke volume 
      (SV), cardiac output (CO), and total peripheral resistance (TPR), were measured 
      noninvasively using continuous arterial pulse wave analysis. RESULTS: BP fell 
      during 2 of the 3 drain/fill periods when dialysate was drained from the 
      peritoneal cavity, but then rose upon instillation of dialysate fluid. The fall 
      in BP was associated with a fall in TPR, matched by an inadequate rise in SV and 
      CO. Over the entire study period, TPR progressively rose to +53.4% above baseline 
      (p = 0.032). Both SV and CO fell over the same period, to -21.1% (p = 0.060) and 
      -22.4% from baseline (p = 0.037) respectively. This did not result in any 
      significant difference between start and end BP. CONCLUSIONS: This study 
      demonstrates that APD is associated with significant systemic hemodynamic 
      effects. The increased number of drain/fill cycles compared to CAPD, or the 
      progressive rise in TPR and reduction in CO (possibly due to a cooling effect), 
      may potentially be factors that adversely affect RRF in APD patients.
FAU - Selby, Nicholas M
AU  - Selby NM
AD  - Department of Renal Medicine, Derby City Hospital, Derby, United Kingdom.
FAU - Fonseca, Sally
AU  - Fonseca S
FAU - Hulme, Lisa
AU  - Hulme L
FAU - Fluck, Richard J
AU  - Fluck RJ
FAU - Taal, Maarten W
AU  - Taal MW
FAU - McIntyre, Christopher W
AU  - McIntyre CW
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Perit Dial Int
JT  - Peritoneal dialysis international : journal of the International Society for 
      Peritoneal Dialysis
JID - 8904033
SB  - IM
CIN - Perit Dial Int. 2006 May-Jun;26(3):306-8. PMID: 16722020
MH  - Aged
MH  - Aged, 80 and over
MH  - Automation
MH  - Blood Pressure/physiology
MH  - Female
MH  - Hemodynamics/*physiology
MH  - Humans
MH  - Kidney Failure, Chronic/etiology/therapy
MH  - Male
MH  - Middle Aged
MH  - Peritoneal Dialysis/*methods
MH  - Peritoneal Dialysis, Continuous Ambulatory/*methods
EDAT- 2006/05/26 09:00
MHDA- 2006/10/06 09:00
CRDT- 2006/05/26 09:00
PHST- 2006/05/26 09:00 [pubmed]
PHST- 2006/10/06 09:00 [medline]
PHST- 2006/05/26 09:00 [entrez]
PST - ppublish
SO  - Perit Dial Int. 2006 May-Jun;26(3):328-35.