Nightly intermittent peritoneal dialysis to initiate peritoneal dialysis

Nightly intermittent peritoneal dialysis (NIPD) with no day dwell has the potential to enhance peritoneal host defenses. We evaluated outcomes in 24 patients who had been placed on NIPD at the start of peritoneal dialysis as compared with outcomes of 24 control patients on standard continuous cycling peritoneal dialysis (CCPD). As compared with patients on CCPD, patients on NIPD had a lower peritonitis rate (0.34 episodes/year vs. 0.59 episodes/year, p < 0.03) and fewer hospital admissions (1.0 admission/year vs. 1.6 admissions/year, p = 0.003). The weekly initial KtV was similar in NIPD and CCPD, but NIPD had significantly higher creatinine clearances owing to higher glomerular filtration rates (GFRs) among the patients (7.8 mL/min vs. 4.8 mL/min, p < 0.02). Technique and patient survival were similar in both groups after controlling for the difference in initial GFR. We conclude that NIPD is a good modality choice for patients starting PD with residual renal function and that it present a low peritonitis risk. As GFR declines, a last fill can be added to maintain adequate clearances.