Abstract: FR-PO1087
Nocturnal Automated vs. Continuous Ambulatory Peritoneal Dialysis in Patients with ESKD: A Multicenter Randomized Crossover Trial
Session Information
- Home Dialysis: Modalities, Barriers, Utilization, and Clinical Outcomes
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Qin, Xianhui, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
- Ai, Jun, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
- Zhang, Lei, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
- Hou, Fan Fan, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
Background
This study evaluated the impact of nocturnal automated peritoneal dialysis (NAPD) supported by AI-based remote supervising on solute clearance and patient-centered outcomes in incident dialysis patients, compared with standard continuous ambulatory peritoneal dialysis (CAPD).
Methods
This is a multicenter, randomized, two-period cross-over trial. 123 incident dialysis patients with non-diabetic end stage kidney disease, on stable peritoneal dialysis in 13 community clinics, were randomly assigned to 12 weeks of NAPD followed by 12 weeks of CAPD, or the reverse. The main measurement was steady-state weekly Kt/V using non-inferiority analysis. Secondary outcomes included the Kidney Disease Quality of Life (KDQOL-36), the WHO Social Disability Screening Schedule (SDSS), sleep architecture, and ambulatory blood pressure.
Results
Of 123 randomized patients (median age 38 years; 62.6% male), 111 completed both periods and were included in the main measurement set. The mean steady-state weekly Kt/V was 1.67 (SD, 0.40) during NAPD period and 1.67 (SD, 0.36) during CAPD period (mean difference 0.01; 95%CI, -0.04 to 0.05). The lower bound of the 95%CI (-0.04) exceeded the non-inferiority margin of -0.1. APD improved KDQOL-36 subscale scores for disease impact, burden, and physical/mental health (all P <0.001), but not for symptoms/problems. NAPD reduced the SDSS total score (mean difference, -1.2; 95%CI, -1.9 to -0.6) and improved occupation, family roles, and social activities (all P <0.05). No significant differences were observed between two arms in ultrafiltration volume, sleep parameters, ambulatory blood pressure, or adverse event rates.
Conclusion
In non-diabetic incident dialysis patients, NAPD was non-inferior to CAPD in solute clearance and significantly improved patient-centered outcomes such as quality of life and social functioning. These findings support NAPD as a preferred strategy for working age patients.