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APD

Automated peritoneal dialysis with sleep•safe harmony and SILENCIA

Automated peritoneal dialysis with sleep•safe harmony and SILENCIA

DISCLAIMER

Not all products and services are cleared or available for sale in all EU countries. Check your country web site for details.

Why automated peritoneal dialysis (APD)?

APD uses a programmable machine, or cycler, that controls the volume, filling, dwell time and drainage of the solution. Thanks to automated dialysis, patients can be dialyzed at home, even when sleeping.

As APD is offering more free daytime, it is the PD technique with obvious advantages for patient’s lifestyle. Patients may pursue a job and have more time for personal and family activities.1

Finally, APD cyclers offer a variety of individualization options for the treatment, allowing you to even better consider the needs of your patient, supporting you to improve patient care.

In APD both our cyclers, sleep•safe harmony and SILENCIA, offer advanced features, all aimed at improving patient care.

In APD both our cyclers, sleep•safe harmony and SILENCIA, offer advanced features, all aimed at improving patient care.

  • Increased treatment flexibility with FlexPoint technology3
  • Integrated on-screen animations give guidance and facilitate setup3
  • As proposed by Fischbach et al., potentially improved ultrafiltration and clearance with individually adapted APD (aAPD)2

Getting started with education in APD – The difficult part was making it easier

FMC created training solutions that focus on conveying the information that really matter and offers support in preparing and setting up the treatment.

2

Preparation

Train

  • Spot-on training videos for caregivers and patients to support training
  • Start with supportive extra training material for our APD devices
  • Set of patient information materials to support you in training the patient

Start

  • Support in planning and preparing the therapeutic home environment

Our products - Key features of the sleep·safe harmony

sleep·safe harmony offers features aimed at improving patient care. It also provides training support by guiding on-screen animations directly on the device.

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Our products - Key features of SILENCIA

Our products - Key features of SILENCIA

SILENCIA is delivering individual APD therapy in a reliable and convenient way, providing the following benefits :

  • Improved sleep quality due to silent operation and soft alarms4,5
  • Simple design enables easy setup and short training time6
  • APD individualization as supported by the latest ISPD guidelines7
  • Developed for home use even with limited space
  • High patient satisfaction with the handling of the SILENCIA cycler
  • Increased treatment flexibility with FlexPoint technology

Adapted APD (aAPD) is one way to personalize treatments

sleep•safe harmony and SILENCIA offer multiple options to individualize prescriptions according to patients' needs. Using our APD cyclersthe prescription can be individualized on several levels:

  • Infusion volume
  • Dwell time
  • Glucose profile
  • Calcium profile
  • FlexPoint

Different PD solutions per cycle within the same treatment can be used with sleep•safe harmony.

Because every patient is different: aAPD – Fischbach et al.2 suggests potential better results using the same time and resources2

Your patients have a chronic disease in common, but differ in many ways: age, height, weight, stage of illness, residual kidney function etc. These differences have a decision impact on the PD treatment required. 
Patients’ needs are different:

Our products - Key features of SILENCIA

Fischbach study supports aAPD2

Fischbach M. et al. conducted a randomized, prospective, cross-over, multicenter study. Nineteen patients were included in the final analysis.

According to Fischbach et al., aAPD offers better results using the same time and resources2

  • aAPD is possible without extra fluids or a longer amount of time
  • Efficiently uses existing treatment resources: better ultrafiltration and clearance with same, low glucose concentration, fluid volume and treatment time compared to conventional APD (cAPD)

Attaining adequacy targets

The aAPD approach was proposed by Fischbach M. et al.2 By combining sequences of short dwells and small fill volumes with long dwells and large fill volumes, aAPD aims to promote UF and clearance within one PD session. The blood purification and UF achieved for every gram of glucose absorbed was higher in aAPD in comparison to cAPD.

The challenges of PD – Reaching adequacy targets

Reaching adequacy targets in PD for both UF and clearance is challenging. Fischbach et al. propose that shorter dwell times and smaller fill volumes promote the process of UF, while longer dwell times and large fill volumes increase solute clearance.2 The proposed strategy may have the potential to improve the two targets within one PD session.

cAPD

aAPD

Figure 1: Modified cAPD graphic following Fischbach M. et al.

Figure 1: Modified cAPD graphic following Fischbach M. et al.

aAPD

Figure 2: Modified aAPD graphic following Fischbach M. et al.

Figure 2: Modified aAPD graphic following Fischbach M. et al.

Adapted APD is possible without extra fluids or a longer amount of time, with the same glucose concentration.

The study results suggest that, compared with cAPD, targeting UF vs. clearance separately, by varying dwell times and fill volumes may improve dialysis adequacy with a reduction in metabolic burden.2

Comparison after 45 days1

Figure 3: Figure created based on study data from Fischbach, M. et al., comparing mean daily UF and sodium removal after 45 days, showing better UF (+100 mL/session) and sodium removal (+14 mmol/session) for aAPD

Figure 3: Figure created based on study data from Fischbach, M. et al., comparing mean daily UF and sodium removal after 45 days, showing better UF (+100 mL/session) and sodium removal (+14 mmol/session) for aAPD

Figure 4: Figure created based on study data from Fischbach, M. et al,. Higher clearance with aAPD over glucose absorbed

Figure 4: Figure created based on study data from Fischbach, M. et al,. Higher clearance with aAPD over glucose absorbed

Summary of potential patient benefits as reported by Fischbach et al2

Patient benefits

  • Improves ultrafiltration
  • Better sodium removal
  • Lower blood pressure
  • Promotes clearance: urea, creatinine, phosphate
  • Reduced metabolic load
     

Clinical value

  • Improved use of existing treatment resources: better ultrafiltration and clearance with same, low glucose concentration, fluid volume and treatment time compared to cAPD

APD monitoring and support

Smart digital tools offer convenience for patients and caregivers in the comfort of the patients’ homes.

3

Treatment

Support

  • A simple ordering process in combination with personal phone support ensures that patients can order materials anytime and anywhere
  • The delivery service ensures that PD solutions and disposables are delivered straight to your patient’s doorstep
  • The PD travel service enables patients to continue travelling as the required goods are directly sent to the patient’s holiday destination*

Monitor

  • Streamlined PD therapy management through easy accessibility to therapy information via our PatientOnLine tool


* The service is not available in all countries. The availability of the service and products must be clarified before planning or booking a vacation.

DISCLAIMER

Not all products and services are cleared or available for sale in all EU countries. Check your country web site for details.

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