The ADEMEX study in this issue of the Journal concludes that currently recommended adequacy guidelines require more peritoneal dialysis. PDF | On Jul 1, , Dante Amato and others published The ADEMEX study: afterthoughts. Abstract. The ADEMEX study was a prospective, randomized, con- trolled, interventional trial that evaluated the effect of an increase in peritoneal clearance on.
|Published (Last):||4 October 2011|
|PDF File Size:||17.2 Mb|
|ePub File Size:||20.71 Mb|
|Price:||Free* [*Free Regsitration Required]|
There is also increasing evidence of the importance of residual renal function in maintaining euvolemia and as a prognostic indicator for survival.
The findings are clinically relevant, but there are some limitations of the study that may limit the generalizability of the results. Subjects in the control group continued to receive their preexisting PD prescriptions, which consisted of four daily exchanges with 2 L of standard PD solution.
Gene Ontology GO Terms. A prospective, randomized, controlled, clinical trial was performed to study the effects of increased peritoneal small-solute clearances on clinical outcomes among patients with end-stage renal disease who were being treated with PD.
The primary endpoint was death. Overall, the control group exhibited a 1-yr survival of First of all, exclusion criteria were likely to result in the exclusion of rapid transporters and small patients, the subgroup of patients found to have an increased relative risk of death on PD in other studies. Residual renal function did predict outcome. Similarly, the intervention group exhibited a 1-yr survival of The ADEMEX study and subsequent investigations have changed the way we perceive the optimal peritoneal dialysis prescription.
Comment in J Am Soc Nephrol. The ADEMEX study was a prospective, randomized, controlled, interventional trial that evaluated the effect of an increase in peritoneal clearance on the relative risk of death for patients on CAPD.
The ADEMEX study and PD adequacy.
Coincident with this finding, there has been increasing awareness that many peritoneal dialysis patients are volume stucy, and that there are adverse cardiovascular consequences to this chronic overhydration.
The ADEMEX study and PD adequacy.
The data confirms a that one size prescription does not fit all; b that many patients below current NKF-DOQI targets for small solute clearance may be adequately dialyzed, and c it provides us with evidence-based data that national societies can consider using when preparing for the next revisions stydy their guidelines. CitePeer Related Articles http: The minimal follow-up period was 2 yr.
A total of subjects were randomly assigned to the intervention or control group in a 1: The prospective randomized controlled ADEMEX study demonstrated no survival advantage of an increased dose of peritoneal small molecule clearance delivered by chronic ambulatory peritoneal dialysis. As a result there has been a shift away from interest in peritoneal small solute clearance with renewed interest in peritoneal removal of salt and water. The study groups were similar with respect to demographic characteristics, causes of renal disease, prevalence of coexisting conditions, residual renal function, peritoneal clearances before intervention, hematocrit values, and multiple indicators of nutritional status.
Secondly, ADEMEX evaluated the effect of an increase in small solute, not middle molecular weight solute clearances on outcome. Find all citations in this journal default. Although several studies have established that patient survival is directly correlated with renal clearances, there have been no randomized, controlled, interventional trials examining the effects of increases in peritoneal small-solute clearances on patient survival.
This study provides evidence that increases in peritoneal small-solute clearances within the range studied have asemex neutral effect on patient survival, even when the groups are stratified according to a variety of factors age, diabetes mellitus, serum albumin levels, normalized protein equivalent of total nitrogen appearance, and anuria known to affect survival.
Small-solute clearance targets for peritoneal dialysis PD have been based on the tacit assumption that peritoneal and renal clearances are equivalent and therefore additive. Read Article adejex publisher’s site. Current Opinion in Nephrology and Hypertension [01 Nov12 6: The results suggest that over the range of solute clearance studied, increasing peritoneal solute clearance had no beneficial effect on survival.
Mortality rates for the two groups remained similar even after adjustment for factors known to be associated with survival for patients undergoing PD e.