Evolution of Automated Peritoneal Dialysis Machines.

Abstract

Peritoneal dialysis (PD) has undergone several improvements over the years. Among the numerous advances, we may recall the improvement in the quality of fluids, safety of catheters and connections, knowledge of the peritoneal membrane in the process of mass transfer separation typical of PD. In parallel with these achievements, PD techniques have also displayed significant improvements mainly due to the evolution of machines and cyclers. Originally, bottles or containers were used to deliver and drain fluid to and from the peritoneal cavity by gravity using manual techniques. Subsequently, the development of semiautomatic or automatic machines have permitted to deliver an adequate treatment during night-time without the need of patient or care giver intervention. These advances solved the problem of treatment delivery, but other aspects including complications and adherence to prescription could only be managed using magnetic cards containing data from different treatments and brought by the patient at the following routinely planned hospital consultation. Today these limitations have been overcome by the new cycler "HOMECHOICE CLARIA" equipped with SHARESOURCE software featuring a bidirectional communication protocol that allows a full remote patient management (RPM). RPM has demonstrated significant advantages including higher technique survival, reduced rate of complications, and reduced costs in patients undergoing long-term PD.