Incremental Versus Standard (Full-Dose) Peritoneal Dialysis

Incremental peritoneal dialysis (PD), defined as less than “standard dose” PD prescription, has a number of possible benefits, including better preservation of residual kidney function (RKF), reduced risk of peritonitis, lower peritoneal glucose exposure, lesser environmental impact, and reduced cos...

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Bibliographic Details
Published in:Kidney international reports 2022-02, Vol.7 (2), p.165-176
Main Authors: Cheetham, Melissa S., Cho, Yeoungjee, Krishnasamy, Rathika, Jain, Arsh K., Boudville, Neil, Johnson, David W., Huang, Louis L.
Format: Article
Language:English
Subjects:
incremental dialysis
patient-centered care
peritoneal dialysis
personalized medicine
quality of life
Review
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Summary:Incremental peritoneal dialysis (PD), defined as less than “standard dose” PD prescription, has a number of possible benefits, including better preservation of residual kidney function (RKF), reduced risk of peritonitis, lower peritoneal glucose exposure, lesser environmental impact, and reduced costs. Patients commencing PD are often new to kidney replacement therapy and possess substantial RKF, which may allow safe delivery of an incremental prescription, often in the form of lower frequency or duration of PD. This has the potential to help improve quality of life (QOL) and life participation through reducing time requirements and burden of treatment. Alternatively, incremental PD could potentially contribute to reduced small solute clearance, fluid overload, or patient reluctance to increase dialysis prescription when later needed. This review discusses the definition, rationale, uptake, potential advantages and disadvantages, and clinical trial evidence pertaining to the use of incremental PD.
ISSN:2468-0249
2468-0249
DOI:10.1016/j.ekir.2021.11.019