APD uses a programmable machine, or cycler, that controls the volume, filling, dwell time and drainage of the solution. Thanks to automated dialysis, patients can be dialyzed at home, even when sleeping.

As APD is offering more free daytime, it is the PD technique with obvious advantages for patient’s lifestyle. Patients may pursue a job and have more time for personal and family activities.1

Finally, APD cyclers offer a variety of individualization options for the treatment, allowing you to even better consider the needs of your patient, supporting you to improve patient care.

FMC created training solutions that focus on conveying the information that really matter and offers support in preparing and setting up the treatment.

sleep·safe harmony offers features aimed at improving patient care. It also provides training support by guiding on-screen animations directly on the device.

Using sleep•safe harmony, the prescription can be individualized on several levels:

Your patients have a chronic disease in common, but differ in many ways: age, height, weight, stage of illness, residual kidney function etc. These differences have a decision impact on the PD treatment required.  Patients’ needs are different:

Age is an important factor influencing the choice of dialysis modality. Patients with good dexterity and motivation are good candidates for PD. With increasing age, the associated comorbidities of dialysis patients might deteriorate and with it their frailty.

Management of weight is an important success factor in PD patients. Changes in weight due to lifestyle, calorie intake, disease and hydration status need constant monitoring and adaptation of PD therapy.

Dialysate to plasma ratio is a common measure used to evaluate peritoneal transport characteristic in PD patients. Patients can be into high (fast), high average and low (slow) transporters based depending upon the status of their peritoneal membrane.  Peritoneal membrane transport characteristics change with time on PD. Therefore, regular monitoring of D/P creatinine and subsequent adjustment of PD prescriptions is recommended.

Patients are classified into high (fast), high average and low (slow) transporters based on the function of their peritoneal membrane. With time and increasing duration of stay on PD, patients tend to become fast transporters. PD prescriptions need to be adapted according to patients' transport status for an optimal patient outcome.

RKF has an impact on patient survival and quality of life of PD dialysis patients. Its longer preservation is a major advantage. Thus, interventions to preserve RKF, like prescription of biocompatible PD fluids, are important.

Due to compromised kidney function, bodies' own capacity to remove excess fluid also diminishes and patients need dialysis to generate UF. The amount of UF needed varies depending upon many factors, like lifestyle, disease progression and other comorbid conditions. An adequate UF is therefore critical for successful PD.

Kt/V urea is urea clearance normalized to total body water. It is an important parameter to check PD adequacy. A total Kt/V urea of at least 1.7 per week is recommended for PD patients.5

Fischbach M. et al. conducted a randomized, prospective, cross-over, multicenter study. Nineteen patients were included in the final analysis.

According to Fischbach et al., aAPD offers better results using the same time and resources2

The aAPD approach was proposed by Fischbach M. et al.2  By combining sequences of short dwells and small fill volumes with long dwells and large fill volumes, aAPD aims to promote UF and clearance within one PD session. The blood purification and UF achieved for every gram of glucose absorbed was higher in aAPD in comparison to cAPD.

Reaching adequacy targets in PD for both UF and clearance is challenging. Fischbach et al. propose that shorter dwell times and smaller fill volumes promote the process of UF, while longer dwell times and large fill volumes increase solute clearance.2 The proposed strategy may have the potential to improve the two targets within one PD session.

Adapted APD is possible without extra fluids or a longer amount of time, with the same glucose concentration.

The study results suggest that, compared with cAPD, targeting UF vs. clearance separately, by varying dwell times and fill volumes may improve dialysis adequacy with a reduction in metabolic burden.2

Smart digital tools offer convenience for patients and caregivers in the comfort of the patients’ homes.

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Fresenius Medical Care offers holistic solutions for CAPD and APD patients, which includes supporting patients in preparing for PD with training solutions and the set up.

The stay•safe system helps patients with daily self-care CAPD treatment in a simple and convenient way.

1 Roumeliotis A et al. Int Urol Nephrol 2021; 53(6):1149-1160

2 Fischbach M et al. Peritoneal Dial Int 2011; 31(4):450-458

3 Punzalan S et al. Journ of Kidn Care 2017; 2(5):262-267

4 Ronco C et al. Nephrol Dial Transplant 2015; 30(5):849-858

5 Tzamaloukas AH et al. Semin Dial 2008; 21(3):250-257

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