NephroCare Independencia, Santiago, Chile.
NephroCare San Bernardo & NephoCare Providencia, Santiago, Chile.
Blood Purif. 2023;52(7-8):668-675. doi: 10.1159/000530464. Epub 2023 Jun 16.
Automated peritoneal dialysis (APD) employs cyclers to control inflow and outflow of the dialysis fluid to the patient's abdomen. To allow more patients to use this modality, cyclers should support the achievement of an adequate dialysis dose and be easy to use, cost-effective, and silent. The new SILENCIA cycler (Fresenius Medical Care, Bad Homburg, Germany), designed to improve these characteristics in comparison to its predecessor device, was evaluated in this respect in a prospective study.
This cross-over study comprised two 2-week study periods, separated by a 3-week training phase. First, patients underwent APD with their current cycler (PD-NIGHT [Fresenius Medical Care, Bad Homburg, Germany] or HomeChoice Pro [Baxter, Deerfield, IL, USA] as control), followed by training on the SILENCIA cycler. Then, patients were switched to the SILENCIA cycler. During each treatment period, we collected data on total Kt/Vurea, ultrafiltration (UF) volume, patient-reported outcomes (sleep quality, among others), and device handling.
Sixteen patients were enrolled; 2 patients terminated the study prematurely before study intervention, 1 patient due to a protocol violation. In 13 patients, total Kt/Vurea and UF could be evaluated. Neither Kt/Vurea nor UF differed significantly between control and SILENCIA cyclers. Out of 10 patients answering the questionnaire on sleep quality after the 2-week phase with the SILENCIA cycler, sleep quality improved in 5 patients; in the other patients, sleep quality was rated unchanged compared to the previously used cycler. The average reported sleep time was 5.9 ± 1.8 h with the PD-NIGHT, 7.2 ± 2.1 h with HomeChoice Pro, and 8.0 ± 1.6 h with the SILENCIA cycler. All patients were much or very much satisfied with the new cycler.
The SILENCIA cycler delivers adequate urea clearance and UF. Importantly, sleep quality improved, possibly related to less caution messages and alarms.
自动化腹膜透析（APD）采用循环机来控制透析液流入和流出患者腹部。为了让更多的患者使用这种模式，循环机应该支持实现足够的透析剂量，并且易于使用、具有成本效益和静音。与前代设备相比，新的 SILENCIA 循环机（费森尤斯医疗保健，德国巴特洪堡）在这些方面进行了评估。
这项交叉研究包括两个为期 2 周的研究期，中间间隔 3 周的培训阶段。首先，患者使用当前的循环机（PD-NIGHT[费森尤斯医疗保健，德国巴特洪堡]或 HomeChoice Pro[百特，美国迪尔菲尔德]作为对照）进行 APD，然后在 SILENCIA 循环机上接受培训。然后，患者切换到 SILENCIA 循环机。在每个治疗期间，我们收集总 Kt/Vurea、超滤量（UF）、患者报告的结果（睡眠质量等）和设备处理数据。
共纳入 16 名患者；2 名患者在研究干预前提前终止研究，1 名患者因违反方案。在 13 名患者中，可评估总 Kt/Vurea 和 UF。在对照和 SILENCIA 循环机之间，Kt/Vurea 和 UF 均无显著差异。在 10 名回答 SILENCIA 循环机 2 周后睡眠质量问卷的患者中，5 名患者的睡眠质量有所改善；在其他患者中，与之前使用的循环机相比，睡眠质量保持不变。使用 PD-NIGHT 的平均报告睡眠时间为 5.9±1.8 小时，使用 HomeChoice Pro 的平均睡眠时间为 7.2±2.1 小时，使用 SILENCIA 循环机的平均睡眠时间为 8.0±1.6 小时。所有患者对新循环机非常满意。
SILENCIA 循环机能提供足够的尿素清除和 UF。重要的是，睡眠质量得到了改善，这可能与减少警示信息和报警有关。
