title: [Incremental peritoneal dialysis - conclusions].
abstract: Peritoneal dialysis (PD) adequacy, defined as the sum of renal clearance and peritoneal clearance with a minimum Kt/V target of 1.70, can be achieved with incremental dialysis (Incr-PD), which should therefore not be confused with early dialysis. The Peritoneal Dialysis Study Group census data show that the use of Incr-PD is widespread in Italy and has increased over the years. In 2010 Incr-PD was used in 50% of the centers performing peritoneal dialysis (PD), against 38.5% in 2008 and 29.2% in 2005. The use of PD is also significantly higher in these centers than in those not using Incr-PD (27.5% vs 21.4%; p<0.001). Despite the widespread use of Incr-PD, there is no evidence in the literature showing significantly different clinical results between starting PD incrementally or on full-dose. However, some data suggest a benefit of Incr-PD in that it favors the choice of PD and is associated with a better quality of life. This method allows for the dialysis adequacy and ultrafiltration targets indicated by the current guidelines to be achieved easily without the risk of underdialysis. In view of the frequent errors in the collection of diuresis and of the progressive reduction over time of residual renal function (RRF), frequent RRF monitoring is necessary so that the dialysis dose can be adjusted. Furthermore, dialysis adequacy should always be measured by collection of the dialysate.
authors: S.O.C. Nefrologia, Dialisi e Nutrizione Clinica, Ospedale San Lazzaro, Alba (CN), Italy. gviglino@aslcn2.it
authors: Giusto
authors: G
authors: Viglino
mesh_terms: D006801:Humans; D010530:Peritoneal Dialysis / Q000379:methods*