Incremental start to PD as experienced in Italy: results of censuses carried out from 2005 to 2014

Neri, Loris; Viglino, Giusto; Marinangeli, Giancarlo; Rocca, Anna Rachele; Laudon, Alessandro; Ragusa, Antonino; Cabiddu, Gianfranca

doi:10.1007/s40620-017-0403-0

Cited by 15 publications

(14 citation statements)

References 16 publications

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“…These patients had greater residual renal function and urinary sodium losses, thus over-all losses were similar between modalities, supporting the results of smaller studies [10, 24]. As with many centres we practice incremental dialysis, with peritoneal dialysis prescriptions taking into account residual renal function [25], and as such patients with greater residual renal function and urinary sodium losses had correspondingly lower peritoneal sodium losses.…”

Section: Discussionmentioning

confidence: 62%

Comparison of sodium removal in peritoneal dialysis patients treated by continuous ambulatory and automated peritoneal dialysis

Maharjan

Davenport

2019

J Nephrol

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BackgroundOptimal fluid balance for peritoneal dialysis (PD) patients requires both water and sodium removal. Previous studies have variously reported that continuous ambulatory peritoneal dialysis (CAPD) removes more or equivalent amounts of sodium than automated PD (APD) cyclers. We therefore wished to determine peritoneal dialysate losses with different PD treatments.MethodsPeritoneal and urinary sodium losses were measured in 24-h collections of urine and PD effluent in patients attending for their first assessment of peritoneal membrane function. We adjusted fluid and sodium losses for CAPD patients for the flush before fill technique.ResultsWe reviewed the results from 659 patients, mean age 57 ± 16 years, 56.3% male, 38.9% diabetic, 24.0% treated by CAPD, 22.5% by APD and 53.5% APD with a day-time exchange, with icodextrin prescribed to 72.8% and 22.7 g/L glucose to 31.7%. Ultrafiltration was greatest for CAPD 650 (300–1100) vs 337 (103–598) APD p < 0.001, vs 474 (171–830) mL/day for APD with a day exchange. CAPD removed most sodium 79 (33–132) vs 23 (− 2 to 51) APD p < 0.001, and 51 (9–91) for APD with a day exchange, and after adjustment for the CAPD flush before fill 57 (20–113), p < 0.001 vs APD. APD patients with a day exchanged used more hypertonic glucose dialysates [0 (0–5) vs CAPD 0 (0–1) L], p < 0.001.ConclusionCAPD provides greater ultrafiltration and sodium removal than APD cyclers, even after adjusting for the flush-before fill, despite greater hypertonic usage by APD cyclers. Ultrafiltration volume and sodium removal were similar between CAPD and APD with a day fill.

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Section: Discussionmentioning

confidence: 62%

Comparison of sodium removal in peritoneal dialysis patients treated by continuous ambulatory and automated peritoneal dialysis

Maharjan

Davenport

2019

J Nephrol

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“…It must be emphasized that IPD is not early dialysis and requires monthly monitoring of RRF to promptly adjust dialytic dosage. Despite little evidence in publications, IPD is widely used, mostly in Italy [ 112 ]. IPD has resulted safe for patients and has shown advantages in terms of lower hospitalization, incidence of peritonitis and rate of decrease in RRF [ 113 ], as well as a lower impact on patient quality of life.…”

Section: Proper Dietetic Nutritional Therapy Can Allow An Integrated mentioning

confidence: 99%

Nutritional treatment of advanced CKD: twenty consensus statements

et al. 2018

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The Italian nephrology has a long tradition and experience in the field of dietetic-nutritional therapy (DNT), which is an important component in the conservative management of the patient suffering from a chronic kidney disease, which precedes and integrates the pharmacological therapies. The objectives of DNT include the maintenance of an optimal nutritional status, the prevention and/or correction of signs, symptoms and complications of chronic renal failure and, possibly, the delay in starting of dialysis. The DNT includes modulation of protein intake, adequacy of caloric intake, control of sodium and potassium intake, and reduction of phosphorus intake. For all dietary-nutritional therapies, and in particular those aimed at the patient with chronic renal failure, the problem of patient adherence to the dietetic-nutritional scheme is a key element for the success and safety of the DNT and it can be favored by an interdisciplinary and multi-professional approach of information, education, dietary prescription and follow-up. This consensus document, which defines twenty essential points of the nutritional approach to patients with advanced chronic renal failure, has been written, discussed and shared by the Italian nephrologists together with representatives of dietitians (ANDID) and patients (ANED).

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“…In realtà, nella pratica quotidiana, è frequente in dialisi peritoneale la prescrizione di una dose dialitica incrementale, vale a dire l’inizio con una dose dialitica ridotta e il successivo aumento della dose in conseguenza al deterioramento della funzione renale residua 1 . Un approccio analogo è stato proposto anche per i pazienti incidenti in trattamento emodialitico cronico utilizzando un ritmo dialitico bisettimanale, quando è presente una sufficiente funzione renale residua.…”

Section: Discussioneunclassified

“…Nella pratica clinica di molti centri per la dialisi peritoneale viene utilizzata una strategia di dose incrementale 1 . Ciò significa che la dialisi viene iniziata con un numero ridotto di scambi giornalieri, che successivamente viene incrementato al ridursi della funzione renale residua (residual renal function, RRF).…”

Section: Introduzioneunclassified

Il ritmo dialitico bisettimanale può essere utilizzato in pazienti selezionati all’avvio del trattamento emodialitico cronico

Cornacchiari¹,

Cosa²,

Martina³

et al. 2018

Giornale di Tecniche Nefrologiche e Dialitiche

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Incremental start to PD as experienced in Italy: results of censuses carried out from 2005 to 2014

Abstract: Incr-PD is used in Italy in a large number of incident PD patients. The reasons for this increase need to be clarified, as current adequacy targets are based on full-dose studies with a very low glomerular filtration rate (GFR).

Cited by 15 publications

References 16 publications

Comparison of sodium removal in peritoneal dialysis patients treated by continuous ambulatory and automated peritoneal dialysis

Comparison of sodium removal in peritoneal dialysis patients treated by continuous ambulatory and automated peritoneal dialysis

Nutritional treatment of advanced CKD: twenty consensus statements

Il ritmo dialitico bisettimanale può essere utilizzato in pazienti selezionati all’avvio del trattamento emodialitico cronico

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