Assisted peritoneal dialysis--an evolving dialysis modality.

switch group and 25.1 days in the late-switch group (þ68% compared with early switch group; P1⁄4 0.13). In the lateswitch group, renal toxicity resulted in an increased hospitalization duration (from 4 to 10 days) in 3 patients (vs. zero patients in the early switch group). In the early switch group, no patients were given dialysis vs. one patient that required two sessions in late-switch group. The cost of drugs was significantly lower in the late switch ( 65%; P1⁄4 0.004) compared with the early-switch group. Although the total cost per patients, including duration of hospitalization from randomization to hospital discharge, dialysis sessions and study drugs, was lower using the early switch strategy (15 729 euros) than in the late switch strategy (19 785 euros), this difference did not attain statistical significance. Thus, the increase in hospitalization duration caused by CAB appears to cancel-out the higher initial cost of L-AmB treatment. In conclusion, this study showed that if even moderate nephrotoxicity develops during CAB treatment, it continuously worsens and sometimes at a very rapid rate. Moreover, these findings suggest that an early switch from CAB to L-AmB as soon as moderate nephrotoxicity appears as well as close monitoring of renal function could preserve renal function and shorten the chemotherapeutic programme of the patient. Finally, the economic data indicate that the early switch strategy is cost-effective because it reduces hospitalization duration.