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[Infrequent and incremental dialysis: differences and definitions]
Piergiorgio Bolasco1, Stefano Murtas2
1Former Director of Territorial Nephrology ASL Cagliari, member of Italian Society of Nephrology and of the Conservative Treatment of CKD study group of the Italian Society of Nephrology.
Summary
Incremental Dialysis (CDDP) offers a tailored approach for patients with declining kidney function, distinct from infrequent dialysis. This method may reduce mortality and preserve residual renal function, warranting further investigation.
Area of Science:
- Nephrology
- Renal Replacement Therapy
Background:
- Distinguishing Incremental Dialysis (CDDP) from Infrequent Dialysis is crucial for therapeutic clarity.
- Infrequent Dialysis involves hemodialytic rhythms below thrice-weekly treatments, requiring close clinical and nutritional monitoring.
- CDDP is a distinct therapeutic strategy demanding significant clinical attention.
Purpose of the Study:
- To clarify the definition and clinical significance of Incremental Dialysis (CDDP).
- To differentiate CDDP from Infrequent Dialysis.
- To highlight the potential benefits of CDDP in managing patients with advanced chronic kidney disease.
Main Methods:
- CDDP involves a pre-dialysis outpatient clinic approach for patients with VFG of 5-10 mL/min/1.73mq.
- Treatment includes a hypoproteic diet (0.6g/Kg/day), essential amino acids, hyposaline diet, and One-Weekly Dialysis.
- The program is individualized based on the trend of Residual Renal Function (FRR).
Main Results:
- CDDP acts as a "bridge" therapy, aiming for good metabolic status and quality of life.
- Preliminary studies suggest lower mortality rates compared to thrice-weekly dialysis.
- CDDP may maintain a neutral phosphorus balance due to preserved phosphaturia, unlike thrice-weekly dialysis which leads to early FRR loss.
Conclusions:
- Incremental Dialysis (CDDP) is a specialized therapeutic program requiring careful management.
- CDDP shows promise in reducing mortality and preserving residual renal function.
- Further research is necessary to validate the safety and efficacy of CDDP.
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