Abstract
Nightly machinery peritoneal dialysis, including continuous cyclic PD (CCPD) and nightly intermittent PD (NPD), provides a new dimension in the field of peritoneal dialysis. They have become more popular in North America and Europe as alternatives to CAPD. The efficiency of dialysis was compared with regard to the clearances of urea, creatinine and phosphate in three patients who were tried sequentially on CAPD, NPD, CAPD+NPD, CCPD and tidal PD (TPD). CAPD plus NPD gave the best clearances, 30-40% higher than CAPD. The clearances of 7-8 hour TPD matched those of CCPD, although they were 5-15% lower than those of CAPD. NPD gave the lowest clearances, 30% less than CAPD. Protein loss seemed to depend on the duration of dialysis. Nocturnal treatments such as TPD and NPD showed almost half as much protein loss as the other 24-hour treatments. Adequate tidal and reserve volume for TPD remain to be studied. Nightly machinery PD has several options, which can minimize CAPD drop out, increase daily activities and increase the indication for peritoneal dialysis. CCPD or TPD provides an excellent alternative for patients requiring chronic dialytic therapy. NPD can supplement CAPD patients who remain underdialyzed despite 4 or 5 exchanges per day.
