Titre du document / Document title

The ADEMEX study: Expanding the boundaries of peritoneal dialysis adequacy beyond small solute clearances

Auteur(s) / Author(s)

ABU-ALFA Ali K. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Peritoneal Dialysis Program, Section of Nephrology, Yale School of Medicine, New Haven, Connecticut, ETATS-UNIS

Résumé / Abstract

Peritoneal small solute clearances have been extensively examined for their effect on the outcome of patients maintained on peritoneal dialysis (PD). Those studies, however, have had conflicting results. ADEMEX, or the ADEquacy of PD in MEXico, is the largest interventional study ever conducted in peritoneal dialysis examining the effects of increased peritoneal small solute clearances on mortality rates among patients on continuous ambulatory peritoneal dialysis (CAPD). Over the entire 2-year study period, the interventions succeeded in achieving a sustained separation between the intervention and control groups with regard to the mean peritoneal weekly creatinine clearance (46.1 vs. 56.9 L/wk/1.73m²) and Kt/V (1.62 vs. 2.13). The results showed a neutral effect of increased peritoneal clearances on mortality, with death rates being similar in both cohorts. As in the CANUSA study, a favorable effect of residual renal function on outcome was again demonstrated in the ADEMEX study. The results highlight the need to broaden the scope of what constitutes adequate dialysis clinical care and therapeutic success beyond small molecule clearances. A comprehensive approach to improve ultrafiltration management, preserve residual renal function, optimize nutritional status, and reduce cardiovascular disease risk factors, in both the pre-dialysis and ESRD phases of chronic kidney disease, will be important in significantly and positively influencing the clinical outcomes in PD patients.

Revue / Journal Title

Dialysis & transplantation   ISSN 0090-2934   CODEN DITRD2 

Source / Source

2003, vol. 32, n^o3, pp. 115-124 [7 page(s) (article)] (47 ref.)

Langue / Language

Anglais

Editeur / Publisher

Creative Age Publications, Van Nuys, CA, ETATS-UNIS  (1972) (Revue)

Mots-clés anglais / English Keywords

Urinary system disease ; America ; Central America ; Cardiovascular disease ; Treatment ; Hemodialysis ; Renal function ; Ambulatory ; Mortality ; Mexico ; Human ; Prognosis ; Creatinine ; Kidney disease ; Peritoneal dialysis ;

Mots-clés français / French Keywords

Appareil urinaire pathologie ; Amérique ; Amérique Centrale ; Maladie cardiovasculaire ; Traitement ; Hémodialyse ; Fonction rénale ; Ambulatoire ; Mortalité ; Mexique ; Homme ; Pronostic ; Créatinine ; Rein pathologie ; Dialyse péritonéale ;

Mots-clés espagnols / Spanish Keywords

Aparato urinario patología ; America ; America central ; Cardiovascular enfermedad ; Tratamiento ; Hemodiálisis ; Función renal ; Ambulatorio ; Mortalidad ; México ; Hombre ; Pronóstico ; Creatinina ; Riñón patología ; Diálisis peritoneal ;

Localisation / Location

INIST-CNRS, Cote INIST : 16542, 35400010421494.0010