Incremental peritoneal dialysis: New ideas about an old approach.

Abstract:

:Coping with the transition from end-stage kidney disease to dialysis can be challenging for patients and their care partners. Introducing incident dialysis patients to incremental forms of dialysis is associated with better quality of life and reduced cost. Incremental hemodialysis (HD) has generated significant interest over the last decade with treatments that focus on clinical criteria rather than prespecified Kt/Vurea targets. Incremental peritoneal dialysis (PD) has traditionally focused on the sum of residual renal and peritoneal clearances to achieve a specific Kt/Vurea value. Gradual increases in the PD dose were prescribed as the residual kidney function declined. Adopting a new approach to incremental PD similar to what has been done for incremental HD would obviate the need for Kt/Vurea and focus exclusively on clinical criteria. New incremental PD may be considered less disruptive to incident dialysis patients, and may be more likely to be accepted as treatment. It will also reduce our obsession with small solute kinetics and enhance encounters with patients by focusing instead on the holisitc clinical assessment.

journal_name

Semin Dial

journal_title

Seminars in dialysis

authors

Auguste BL,Bargman JM

doi

10.1111/sdi.12712

subject

Has Abstract

pub_date

2018-09-01 00:00:00

pages

445-448

issue

5

eissn

0894-0959

issn

1525-139X

journal_volume

31

pub_type

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