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.
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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.
Residual renal function did predict outcome.
First adrmex 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.
This has resulted in de-emphasis of peritoneal small molecule clearance and increased emphasis on clinical assessment of dialysis adequacy, preservation of residual renal function, and optimization of salt and water removal. Current Opinion in Nephrology and Hypertension [01 Nov12 6: Wtudy ADEMEX study and subsequent tsudy have changed the way we perceive the optimal peritoneal dialysis prescription.
Overall, the control group exhibited a 1-yr survival of Coincident with this finding, there has been increasing awareness that many peritoneal dialysis patients are volume expanded, and that there are adverse cardiovascular consequences to this chronic overhydration. Find all citations in this journal default. 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.
Mortality rates for the two groups remained similar even after adjustment for factors known to be associated with tsudy for patients undergoing PD e. 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.
The ADEMEX study and PD adequacy.
Secondly, ADEMEX evaluated the effect of an increase in small solute, not admex molecular weight solute clearances on outcome. 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. This review examines the results of the ADEMEX Adequacy of Peritoneal Dialysis in Mexico study in the context of other recent advances in peritoneal dialysis, and assesses the implication of this new knowledge for the optimal peritoneal dialysis prescription.
The minimal follow-up period was 2 yr. CitePeer Related Articles http: Read Article at publisher’s site.
How does Europe PMC derive its citations network? Comment in J Am Soc Nephrol. The study groups were similar ztudy 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.
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. The findings are clinically relevant, but there are some limitations of the study that may limit the generalizability of the results.
The ADEMEX study and PD adequacy.
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 ademfx disease who were being treated with PD. This study provides evidence that increases in peritoneal small-solute clearances within the range studied have a 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 ademsx known to affect survival.
No clear survival advantage was obtained with increases in peritoneal small-solute clearances within the range achieved in this study.