Incremental peritoneal dialysis: a 10 year single-centre experience.
J Nephrol
; 29(6): 871-879, 2016 Dec.
Article
de En
| MEDLINE
| ID: mdl-27582136
ABSTRACT
INTRODUCTION:
Incremental dialysis consists in prescribing a dialysis dose aimed towards maintaining total solute clearance (renal + dialysis) near the targets set by guidelines. Incremental peritoneal dialysis (incrPD) is defined as one or two dwell-times per day on CAPD, whereas standard peritoneal dialysis (stPD) consists in three-four dwell-times per day. PATIENTS ANDMETHODS:
Single-centre cohort study. Enrollement period January 2002-December 2007; end of follow up (FU) December 2012. INCLUSION CRITERIA incident patients with FU ≥6 months, initial residual renal function (RRF) 3-10 ml/min/1.73 sqm BSA, renal indication for PD.RESULTS:
Median incrPD duration was 17 months (I-III Q 10; 30). There were no statistically significant differences between 29 patients on incrPD and 76 on stPD regarding clinical, demographic and anthropometric characteristics at the beginning of treatment, adequacy indices, peritonitis-free survival (peritonitis incidence 1/135 months-patients in incrPD vs. 1/52 months-patients in stPD) and patient survival. During the first 6 months, RRF remained stable in incrPD (6.20 ± 2.02 vs. 6.08 ± 1.47 ml/min/1.73 sqm BSA; p = 0.792) whereas it decreased in stPD (4.48 ± 2.12 vs. 5.61 ± 1.49; p < 0.001). Patient survival was affected negatively by ischemic cardiopathy (HR 4.269; p < 0.001), peripheral and cerebral vascular disease (H2.842; p = 0.006) and cirrhosis (2.982; p = 0.032) and positively by urine output (0.392; p = 0.034). Hospitalization rates were significantly lower in incrPD (p = 0.021). Eight of 29 incrPD patients were transplanted before reaching full dose treatment.CONCLUSIONS:
IncrPD is a safe modality to start PD; compared to stPD, it shows similar survival rates, significantly less hospitalization, a trend towards lower peritonitis incidence and slower reduction of renal function.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Dialyse péritonéale
/
Rein
/
Maladies du rein
Type d'étude:
Diagnostic_studies
/
Etiology_studies
/
Evaluation_studies
/
Guideline
/
Observational_studies
/
Risk_factors_studies
Limites:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Pays/Région comme sujet:
Europa
Langue:
En
Journal:
J Nephrol
Sujet du journal:
NEFROLOGIA
Année:
2016
Type de document:
Article
Pays d'affiliation:
Italie