Compliance in automated peritoneal dialysis.

In peritoneal dialysis (PD), compliance with the dialytic prescription is an important element in achieving adequate dialysis. Using the questionnaire or inventory method, a rate of noncompliance between 10% and 20% has been reported for automated peritoneal dialysis (APD). The recent introduction of APD equipment capable of recording dialytic treatments (DTs) means that compliance can be assessed more precisely. In the present study, the PDLink software program (Baxter Healthcare Corporation, Deerfield, IL, U.S.A.) was used to retrospectively analyze 3 consecutive months of DTs in 19 APD patients (15 men, 4 women; age: 67.9 +/- 10.2 years; duration of PD: 36.3 +/- 30.0 months) who were treated with the HomeChoice Pro [HCpro (Baxter Healthcare Corporation, Deerfield, IL, U.S.A.)]. In 12 patients (63%), the treatment was self-administered; for the other 7 patients (37%), treatment was handled by a partner (spouse: 5; family member: 2). Of 1673 recorded DTs, 20 (1.2%) were not performed. In the period taken into consideration (90 consecutive days), 9 patients underwent all the prescribed sessions, 4 patients missed 1 session, 3 patients missed 2 sessions, 2 patients missed 3 sessions, and 1 patient missed 4 sessions. No irregularities were observed in relation to the prescribed volumes, and session length was 60-120 minutes shorter in only 0.12% of the recorded sessions. In conclusion, the HCpro system proved effective in assessing compliance. In our experience, noncompliance occurred in a lower percentage of cases than has previously been reported, notwithstanding the present method's greater sensitivity and lesser specificity.