Preliminary evaluation of incremental peritoneal dialysis in 25 patients

Abstract

Background: Incremental dialysis has been suggested for patients with some residual renal function. However, very little published clinical data exist on the feasibility of this schedule.

Objectives: To assess feasibility of incremental dialysis, with regard to its effect, complications, and impact on quality of life.

Design: Pilot prospective study, not controlled.

Setting: Nephrology division, public clinical research hospital.

Patients: Twenty-five patients (19 men, mean age 61+/-13 years, body weight 63+/-11 kg) began peritoneal dialysis (the first treatment of uremia) with a single nightly exchange lasting 10 hours or 2 daily exchanges over 12 hours according to creatinine clearance and Kt/N. Patients gave informed consent and reported their work activity, degree of rehabilitation, and their quality of life by answering a questionnaire prepared for this purpose.

Outcome measures: Survival rate, complications related to peritoneal dialysis, and residual renal and peritoneal clearances.

Results: During the study period no patient died. Complications related to dialysis were peritonitis (0.41 episodes/year) and exit-site infection (0.32 episodes/year). All patients continued to work with full rehabilitation and considered 1 or 2 exchanges per day less troublesome than 3 or 4.

Conclusions: Incremental dialysis is well accepted by patients and staff. This technique does not involve a high risk of complications and is economical. Therefore incremental dialysis is feasible.