Incremental peritoneal dialysis with days off vs standard-dose peritoneal dialysis: a propensity-matched study (PD...

The benefits of incremental peritoneal dialysis (IPD) with days off remain controversial. This study aimed to compare the survival rate between IPD with days off and standard-dose peritoneal dialysis (PD).

Participants who started continuous peritoneal dialysis (CAPD) between October 1, 2020 and November 30, 2021, in a tertiary hospital in Thailand were enrolled. IPD with two days off (performed 5 days a week) and standard-dose PD (performed every day) were compared using propensity score matching at a 1:1 ratio for baseline characteristics. The primary outcome was 1-year patient survival. One-year PD continuation rate, PD-associated peritonitis rate, admission rate, and weekly Kt/V at 6 weeks, 6 months, and 12 months were analyzed.

The 118 eligible patients (37 IPD and 81 standard-dose PD) were included. After propensity score matching, the groups were compared. One-year patient survival rates were comparable between groups, with no statistically significant difference (94.3% vs. 97.4% in the IPD and standard-dose PD groups, respectively; hazard ratio (HR) 2.15, 95% confidence interval (CI) 0.19-23.75). The 1-year PD continuation, PD-associated peritonitis rate, and admission rate were comparable between groups. Total weekly Kt/V over the 12 months showed no significant change over time.

IPD with days off appears to be safe and comparable to standard-dose PD in terms of short-term patient survival.