| [ Summary ] |
In an attempt to enhance the removal efficiency of small molecular substances with continuous ambulatory peritoneal dialysis (CAPD), we have developed two types of continuous regeneration systems, continuous recirculating peritoneal dialysis (CRPD) and bi-directional peritoneal dialysis (BPD). In CRPD, part of the dialysate in the patient's peritoneal cavity continuously extracorporates through a newly developed double-lumen catheter and is purified by an outside dialyzer. In BPD, part of the dialysate reciprocates between the peritoneal cavity and an outside reservoir via a reversible pump, which gives the system alternating drain phases and infusion phases. In both phases, the outside dialyzer continually purifies the peritoneal dialysate. Higher removal efficiency for urea and creatinine in CRPD / BPD in comparison with CAPD was obtained in a canine ex vivo study and a clinical study. CRPD / BPD may be expected to be a valuable PD system, because it has some advantages over CAPD, such as usage of bicarbonate supplemented from the outside dialysate, no leakage of albumin using the dialysis membrane of an outside dialyzer etc. |