Response to inadequate dialysis in chronic peritoneal dialysis patients. Results from the 2000 Centers for Medicare and Medicaid (CMS) ESRD Peritoneal Dialysis Clinical Performance Measures (PD-CPM) Project

Profiles of automated peritoneal dialysis prescriptions in the US 1997–2003

Automated peritoneal dialysis (PD) is the dominant mode of delivery of PD in the US. Information about actual prescribing patterns has been limited. The present study examines cycler prescription use in large cohorts during the years 1997, 2000, and 2003. We observed trends consisting of increasing fill volumes, increasing time on cycler, lowering of the number of cycles, and a shift in the reason for utilization of tidal therapy. Monitoring of practice patterns is beneficial in identifying opportunities for practice enhancement. The findings of the present survey demonstrate trends that approach standard recommendations of the benefits of increasing fill volume whereas paying close attention to dwell time as a balance between cycle number and therapy duration. Furthermore, this survey shows that the cycler represents a flexible method to personalize PD therapy.