BACKGROUND: It is well known that the efficiency of @entity298 ( @entity298 ) varies with the duration of the dwell and with the prescribed fill volume. @entity298 ( @entity2195 ) is classically given as a series of recurrent exchanges, each having the same dwell time and fill volume-that is, conventional @entity2195 ( @entity2195 ). We propose a new way of giving @entity298 , using a modified version of @entity2195 . This method first uses a short dwell time with a small fill volume to promote ultrafiltration (UF) and subsequently uses a longer dwell time and a larger fill volume to promote @entity1381 from the blood. We use the term "adapted @entity2195 " ( @entity2195 -A) to describe this modified form of @entity298 . METHODS: We designed a multicenter prospective randomized crossover trial to assess the impact of @entity2195 -A in comparison with @entity2195 on the efficacy of dialysis. The parameters investigated were overnight UF; weekly peritoneal Kt/V( @entity1133 ); weekly peritoneal @entity1011 clearance corrected to 1.73 m(2) body surface area (K(creat)); and @entity1391 ( @entity1106 ) and @entity1372 dialytic removal (SDR) in millimoles per session, corrected for @entity413 absorption, which provides an estimate of metabolic cost. Blood pressure was also regularly monitored. Initially, 25 @entity1 were identified for inclusion in the study. There were 6 withdrawals in total: 2 at enrolment, 1 at day 75 (transplantation), 2 at day 30 ( @entity409 ), and 1 for @entity12967 . All @entity1 received the same duration of overnight @entity2195 , using the same total volume of dialysate, with the same 1.5% @entity413 , @entity880 -buffered dialysate (Balance: Fresenius Medical Care, Bad Homburg, Germany). RESULTS: Tolerance was good. Compared with @entity2195 , @entity2195 -A resulted in a significant enhancement of Kt/V( @entity1133 ), K(creat), and @entity1106 . The metabolic cost, in terms of @entity413 absorption, required to achieve dialytic capacity for @entity1133 , @entity1011 , and @entity1391 blood purification was significantly lower for @entity2195 -A than for @entity2195 , and UF increased during @entity2195 -A. With @entity2195 -A, each gram of @entity413 absorbed contributed to 18.25    15.82 mL UF; in @entity2195 , each gram of @entity413 absorbed contributed to 15.79    11.24 mL UF. However, that difference was not found to be significant (p=0.1218). The SDR was significantly higher with @entity2195 -A than with @entity2195 : 35.23    52.00 mmol and 18.35    48.68 mmol per session respectively (p<0.01). The mean blood pressure recorded at the end of each @entity298 period (on day 45) was significantly lower when @entity1 received @entity2195 -A than when they received @entity2195 . CONCLUSIONS: Our study provides evidence that, compared with the uniform dwell times and fill volumes used throughout an @entity2195 dialysis session, the varying dwell times and fill volumes as described for an @entity2195 -A dialysis session result in improved dialysis efficiency in terms of UF, Kt/V( @entity1133 ), K(creat), @entity1106 , and SDR. Those results were achieved without incurring any extra financial costs and with a reduction in the metabolic cost (assessed using @entity413 absorption).

The beneficial influence on the effectiveness of automated XXXX of varying the dwell time (short/long) and fill volume (small/large): a randomized controlled trial.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity12967 :: ('MESH:D051270', 'Disease') :: ['drainage alarms'] @entity1133 :: ('MESH:D014508', 'Chemical') :: ['urea'] @entity1106 :: ('MESH:C564461', 'Disease') :: ['PDR'] @entity409 :: ('MESH:D008107', 'Disease') :: ['catheter dysfunction'] @entity1372 :: ('MESH:D012964', 'Chemical') :: ['sodium'] @entity413 :: ('MESH:D005947', 'Chemical') :: ['glucose'] @entity1391 :: ('CHEBI:26020', 'Chemical') :: ['phosphate'] @entity880 :: ('MESH:D019344', 'Chemical') :: ['lactate'] @entity1011 :: ('MESH:D003404', 'Chemical') :: ['creatinine'] @entity2195 :: ('OMIM:211750', 'Disease') :: ['APD', 'APD-C'] @entity1381 :: ('MESH:D006463', 'Disease') :: ['removal of uremic toxins'] @entity298 :: ('MESH:D010538', 'Disease') :: ['Automated PD', 'peritoneal dialysis', 'PD']
@entity298 :: (MESH:D010538,Disease) :: ['peritoneal dialysis']
