Patient Outcomes of a Two-Exchange Assisted Continuous Ambulatory Peritoneal Dialysis (CAPD) Programme for Frail Older Patients
Bibliographic record
Abstract
Background: Recognising the burden that hospital haemodialysis (HD) places on frail people in terms of time away from home, transport and haemodynamic shifts, we developed a 2-exchange assisted CAPD (aCAPD) programme to enable this group to receive a home-based therapy. Eligible patients include frail, mostly elderly patients who are symptomatic from advanced kidney disease and have residual kidney function. The focus of the programme is to optimise patients’ symptoms while avoiding a high treatment burden. Methods: In this observational study, all 2-exchange aCAPD patients attending for routine review are approached for assessment. Frailty is assessed with the Edmonton Frail Scale (EFS), cognitive function with the Montreal Cognitive Assessment (MOCA), treatment satisfaction with the Renal Treatment Satisfaction Questionnaire (RTSQ) and symptoms with the Palliative Outcome Scale-Symptom Renal (POS-S Renal). Data was collected via patient interviews and chart review. Results: Of the 17 patients currently receiving 2-exchange aCAPD, results have been collected from 47% (N=8) to date. Mean age is 82 years (77-90) and 50% are male. Mean number of co-morbidities was 4.4. Mean time on 2-exchange aCAPD was 9 months (0-24). 63% had at least mild frailty with an EFS of >8/17 (3-11). 75% had memory impairment with a MOCA <26/30 (8-30). Median number of hospital admissions was 1 (0-3). 38% have travelled outside of the UK (with family support) since commencing aCAPD. 85% reported high satisfaction with treatment with a RTSQ of >55/66 (median 62). Patients reported a low symptom score with a median POS-S Renal of 14.5 (7-27). Pain, lack of energy and poor mobility were the most commonly reported symptoms. Conclusions: Our results demonstrate a frail, elderly population with multiple comorbidities. Although our population number is small and they are not matched to the assisted PD and HD populations published in the FEPOD study they do compare favourably in terms of the RTSQ score; median of 60 vs 55 for assisted PD and 60 vs 51 for HD. Our population was comparable to both groups in terms of the POS-S Renal symptom scores; 14.5 vs 14 for assisted PD and 14.5 vs 16 for HD. This indicates that 2-exchange aCAPD could potentially become the dialysis modality of choice for the frail, older person requiring dialysis.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".