University of Washington, Seattle, WA.
Wake Forest University, Winston-Salem, NC.
Am J Kidney Dis. 2014 Jun;63(6):1027-37. doi: 10.1053/j.ajkd.2013.11.025. Epub 2014 Jan 11.
Automated methods for delivering peritoneal dialysis (PD) to persons with end-stage renal disease continue to gain popularity worldwide, particularly in developed countries. However, the endeavor to automate the PD process has not been advanced on the strength of high-level evidence for superiority of automated over manual methods. This article summarizes available studies that have shed light on the evidence that compares the association of treatment with continuous ambulatory PD or automated PD (APD) with clinically meaningful outcomes. Published evidence, primarily from observational studies, has been unable to demonstrate a consistent difference in residual kidney function loss rate, peritonitis rate, maintenance of euvolemia, technique survival, mortality, or health-related quality of life in individuals undergoing continuous ambulatory PD versus APD. At the same time, the future of APD technology appears ripe for further improvement, such as the incorporation of voice commands and expanded use of telemedicine. Given these considerations, it appears that patient choice should drive the decision about PD modality.
自动化腹膜透析（PD）在全球范围内继续受到关注，特别是在发达国家。然而，由于缺乏自动化方法优于手动方法的高级别证据，自动化 PD 过程的努力并未取得进展。本文总结了现有研究，这些研究阐明了比较连续流动 PD 或自动化 PD（APD）治疗与临床相关结局关联的证据。已发表的证据主要来自观察性研究，未能证明接受连续流动 PD 与 APD 的个体之间残余肾功能丧失率、腹膜炎发生率、容量维持、技术生存率、死亡率或健康相关生活质量的差异具有一致性。与此同时，APD 技术的未来似乎有望进一步改善，例如纳入语音指令和扩大远程医疗的使用。有鉴于此，似乎应该由患者选择来决定 PD 模式。
