Adapted automated peritoneal dialysis (aAPD), comprising a sequence of dwells with different durations and fill volumes, has been shown to enhance both ultrafiltration and solute clearance compared to standard peritoneal dialysis with constant time and volume dwells. The aim of this non-interventional study was to describe the different prescription patterns used in aAPD in clinical practice and to observe outcomes characterizing volume status, dialysis efficiency, and residual renal function over 1 year. Prevalent and incident, adult aAPD patients were recruited during routine clinic visits, and aAPD prescription, volume status, residual renal function and laboratory data were documented at baseline and every quarter thereafter for 1 year. Treatments were prescribed according to the nephrologist's medical judgement in accordance with each center's clinical routine. Of 180 recruited patients, 160 were analyzed. 27 different aAPD prescription patterns were identified. 79 patients (49.4%) received 2 small, short dwells followed by 3 long, large dwells. During follow-up, volume status changed only marginally, with visit mean values ranging between 1.59 (95% confidence interval: 1.19; 1.99) and 1.97 (1.33; 2.61) L. Urine output and creatinine clearance decreased significantly, accompanied by reductions in ultrafiltration and Kt/V. 25 patients (15.6%) received a renal transplant and 15 (9.4%) were changed to hemodialysis. Options for individualization offered by aAPD are actually used in practice for optimized treatment. Changes observed in renal function and dialysis efficiency measures reflect the natural course of chronic kidney disease. No safety events were observed during the study period.

Department of Nephrology and Clinical Research Centre Hospital Serdang Selangor Malaysia

Department of Nephrology Hospital Selayang Selangor Malaysia

Fresenius Medical Care Global Medical Office Bad Homburg Germany

Nefrologia e dialisi ASST Bergamo Ovest Treviglio Italy

Nephrology Complejo Hospital Universitario de Santiago Santiago de Compostela Spain

Nephrology Hospital Clinic de Barcelona Barcelona Spain

Nephrology Hospital Kuala Lumpur Kuala Lumpur Malaysia

Nephrology Hospital Trebic Trebic Czech Republic

Nephrology Hospital Universitario di Girona Josep Trueta Girona Spain

Nephrology NC Centre Sokolov Sokolov Czech Republic

Universiti Kebangsaan Malaysia Kuala Lumpur Malaysia

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