Preliminary evaluation of incremental peritoneal dialysis in 25 patients

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 i ts 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 weig ht 63 +/- 11 kg) began peritoneal dialysis (the first treatment of uremia) with a single nightly exchange lasting 10 hours or 2 daily exchanges over 1 2 hours according to creatinine clearance and Kt/V. Patients gave informed consent and reported their work activity, degree of rehabilitation, and the ir quality of life by answering a questionnaire prepared for this purpose, Outcome Measures: Survival rate, complications related to peritoneal dialys is, 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 (0.3 2 episodes/year). All patients continued to work with full rehabilitation a nd considered 1 or 2 exchanges per day less troublesome than 3 or 4, Conclusions: Incremental dialysis is well accepted by patients and staff. T his technique does not involve a high risk of complications and is economic al, Therefore incremental dialysis is feasible.