Survival of Functionally Anuric Patients on Automated Peritoneal Dialysis: The European APD Outcome Study

Edwina A. Brown*, Simon J. Davies, Peter Rutherford, Frederique Meeus, Mercedes Borras, Werner Riegel, Jose C. Divino Filho, Edward Vonesh, Monique Van Bree

*Corresponding author for this work

Research output: Contribution to journalArticle

307 Scopus citations

Abstract

The European APD Outcome Study (EAPOS) is a 2-yr, prospective, multicenter study of the feasibility and clinical outcomes of automated peritoneal dialysis (APD) in anuric patients. A total of 177 patients were enrolled with a median age of 54 yr (range, 21 to 91 yr). Previous median total time on dialysis was 38 mo (range, 1.6 to 259 mo), and 36% of patients had previously been on hemodialysis for >90 d. Diabetes and cardiovascular disease were present in 17% and 46% of patients, respectively. The APD prescription was adjusted at physician discretion to aim for creatinine clearance (Ccrea) ≥60 L/wk per 1.73 m2 and ultrafiltration (UF) ≥750 ml/24 h during the first 6 mo. Baseline solute transport status (D/P) was determined by peritoneal equilibration test. At 1 yr, 78% and 74% achieved Ccrea and UF targets, respectively; median drained dialysate volume was 16.2 L/24 h with 50% of patients using icodextrin. Baseline D/P was not related to UF achieved at 1 yr. At 2 yr, patient survival was 78% and technique survival was 62%. Baseline predictors of poor survival were age (>65 yr; P = 0.006), nutritional status (Subjective Global Assessment grade C; P = 0.009), diabetic status (P = 0.008), and UF (<750 ml/24 h; P = 0.047). Time-averaged analyses showed that age, Subjective Global Assessment grade C and diabetic status predicted patient survival with UF the next most significant variable (risk ratio, 0.5/L per d; P = 0.097). Baseline Ccrea, time-averaged Ccrea, and baseline D/P had no effect on patient or technique survival. This study shows that anuric patients can successfully use APD. Baseline UF, not Ccrea or membrane permeability, is associated with patient survival.

Original languageEnglish (US)
Pages (from-to)2948-2957
Number of pages10
JournalJournal of the American Society of Nephrology
Volume14
Issue number11
DOIs
StatePublished - Nov 1 2003

ASJC Scopus subject areas

  • Nephrology

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    Brown, E. A., Davies, S. J., Rutherford, P., Meeus, F., Borras, M., Riegel, W., Divino Filho, J. C., Vonesh, E., & Van Bree, M. (2003). Survival of Functionally Anuric Patients on Automated Peritoneal Dialysis: The European APD Outcome Study. Journal of the American Society of Nephrology, 14(11), 2948-2957. https://doi.org/10.1097/01.ASN.0000092146.67909.E2