Treatment failure in automated peritoneal dialysis and double-bag continuous ambulatory peritoneal dialysis

Aim Automated peritoneal dialysis (APD) and double‐bag continuous ambulatory peritoneal dialysis (CAPD) are the two current standard modalities of peritoneal dialysis (PD). Outcomes of these two modalities have not been well described. Methods A single‐centre, retrospective review was carried out to compare the treatment failure rate of APD and double‐bag CAPD. Treatment failure was a combined endpoint including death and technique failure. Cox regression was used to compare risk (hazard ratio, HR) of treatment failure in APD and CAPD. Results There were 121 patients included in this study, 55 with APD and 66 with CAPD. APD patients had significantly lower risk of treatment failure (death and technique failure) than CAPD patients (HR 0.58, 95% confidence interval [CI]: 0.37–0.91, P = 0.02). The lower risk of treatment failure in APD compared to CAPD was mainly caused by the significantly lower risk of technique failure (HR 0.30, 95%CI: 0.10–0.93, P = 0.04). The mortality rates of the two modalities were not significantly different (HR 0.69, 95%CI: 0.42–1.12, P = 0.13). Conclusion Our data suggest that APD may have lower risk of treatment failure compared with double‐bag CAPD. These potential benefits of APD might justify the use of this modality despite its higher cost. Summary at a Glance This study looks at the outcome of patient on APD versus CAPD at a single centre in Thailand. While this is a small retrospective study in a single centre, it is the only data on APD coming out of a country with a huge PD population from a PD first policy. Results of this study are important for policy crafting in Thailand.