Automated Peritoneal Dialysis: An alternative to Continuous Ambulatory or a First Choice Treatment?

Abstract The use of the various forms of Automated Peritoneal Dialysis (APD) has considerably increased in the past few years. This increase is driven by improved cycler design, apparent lifestyle advantages, and the increased ability to achieve adequacy and ultrafiltration targets. It is therefore reasonable to raise the question whether APD is superior to Continuous Ambulatory Peritoneal Dialysis (CAPD). APD is considered the most suitable Peritoneal Dialysis (PD) modality for high transporters as well as for assisted PD. It has also been associated with improved compliance, lower intraperitoneal pressure and possibly lower incidence of peritonitis. On the other hand, there are concerns regarding increased cost, a more rapid decline in residual renal function, inadequate sodium removal and disturbed sleep. Besides its beneficial results in high transporters, other medical advantages of APD still remain unclear. Individual patient’s choice remains the most important indication for applying APD, which should be made available to all patients starting PD.