APD schedules and clinical results

Improving cycler prescriptions in peritoneal dialysis through informatic profiling

Cycler-based dialysis is the most common form of peritoneal dialysis in the United States of America, accounting for more than two thirds of patients on the modality. The advent of modern cyclers has enhanced the accessibility of therapy-delivery data. Cyclers have transformed peritoneal dialysis from an unobserved home therapy into an observable home therapy on many levels. We will discuss 3 of these levels herein. The ability to profile prescription behavior at a population level with attention to fill volume, number of cycles used per night, and total time on the cycler will be analyzed. Insights into the dynamics of flow during cycler therapy and the concept of transition point will then be explored. Finally, we will review the impact on patient care of making the delivery of the dialysis prescription easily observable to the medical team. It is our contention that these 3 levels of profiling offer practical lessons to enhance delivery of care for patients on cycler-based peritoneal dialysis.