Are USPD patients suitable for incremental peritoneal dialysis: Yes or no?

Area of Science:

• Nephrology
• Renal Replacement Therapy

Background:

• Incremental peritoneal dialysis (IPD) involves initiating PD exchanges less than 4 times daily, considering residual renal function (RRF).
• Urgent-start peritoneal dialysis (USPD) patients often require rapid initiation of dialysis therapy.

Purpose of the Study:

• To evaluate the feasibility of using IPD for USPD patients.
• To compare the impact of IPD versus full-dose PD on RRF in USPD patients.

Main Methods:

• Retrospective analysis of 169 USPD patients with eGFR 4-6 mL/min/1.73m² over 1 year.
• Patients were divided into incremental PD (i-PD, dialysis dose ≤ 6,000 mL) and full-dose PD (f-PD, dialysis dose ≥ 8,000 mL) groups.
• Comparison of demographics, clinical indices, peritoneal transport, dialysis adequacy, and complications.

Main Results:

• Demographics and pre-dialysis clinical indices were similar between the i-PD (n=111) and f-PD (n=58) groups.
• Dialysis dose was higher in the f-PD group, with comparable dialysis adequacy in both.
• Peritoneal transport, RRF, blood pressure control, anemia, and mineral metabolism were similar. PD-related infections and mechanical complications were also similar.

Conclusions:

• IPD does not lead to a rapid decline in RRF in USPD patients.
• IPD demonstrates similar dialysis efficacy and complication rates compared to f-PD.
• USPD patients can be safely and effectively treated with IPD.