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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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. Find all citations in this journal default.

Mortality rates for the two groups remained similar even after adjustment for factors known to be associated with survival for patients undergoing PD e. Gene Ontology GO Terms. Secondly, ADEMEX evaluated the effect of an increase in small solute, not middle molecular weight solute clearances on outcome.

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. 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.

CitePeer Related Articles http: The results suggest that over the range of solute clearance studied, increasing peritoneal solute clearance had no beneficial effect on survival. Residual renal function did predict outcome.

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.


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The Stuxy study and subsequent investigations have changed the way we perceive the optimal peritoneal dialysis prescription. 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.

No clear survival advantage was obtained with increases in peritoneal small-solute clearances within the range achieved in this study. Overall, the control group exhibited a 1-yr survival of shudy The data confirms a stidy 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 of their guidelines.

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. Europe PMC requires Javascript to function effectively.

Read Article at publisher’s site. Although several studies have established that patient survival is directly correlated with renal wtudy, there have been no randomized, controlled, interventional trials examining the effects of increases in peritoneal small-solute clearances on patient survival.

Current Opinion in Nephrology and Hypertension [01 Nov12 6: The primary endpoint was death. 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.

Either your web browser doesn’t support Javascript or it is currently turned off. 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. A total of subjects were randomly assigned to the intervention or control group in a 1: 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.

Comment in J Am Soc Nephrol. Or filter your current search. The daemex follow-up period was 2 yr. There is also increasing evidence of the importance of residual renal function in maintaining euvolemia and as a prognostic indicator for survival.

The ADEMEX study and PD adequacy.

Similarly, the intervention group exhibited a 1-yr survival of 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 anuria known to affect survival. As a result there has been a shift away from studdy in tsudy small solute clearance with renewed interest in peritoneal removal of salt and water.

How does Europe PMC derive its citations network? 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. 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.