Kidney Week

Abstract: TH-PO376

Incremental Peritoneal Dialysis Is Beneficial in Preserving Residual Renal Function, Compared to Full-Dose Peritoneal Dialysis

Session Information

• Dialysis: Peritoneal Dialysis - I
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 703 Dialysis: Peritoneal Dialysis

Authors

• Lee, Yeonhee, Seoul National University College of Medicine, Seoul, Korea (the Republic of)

Yeonhee Lee,

• Park, Seokwoo, Seoul National University College of Medicine, Seoul, Korea (the Republic of)

Seokwoo Park,

• Han, Seung Seok, Seoul National University College of Medicine, Seoul, Korea (the Republic of)

Seung Seok Han,

• Lee, Hajeong, Seoul National University College of Medicine, Seoul, Korea (the Republic of)

Hajeong Lee,

• Kim, Dong Ki, Seoul National University College of Medicine, Seoul, Korea (the Republic of)

Dong Ki Kim,

• Joo, Kwon Wook, Seoul National University College of Medicine, Seoul, Korea (the Republic of)

Kwon Wook Joo,

• Ahn, Curie, Seoul National University College of Medicine, Seoul, Korea (the Republic of)

Curie Ahn,

• Oh, Kook-Hwan, Seoul National University College of Medicine, Seoul, Korea (the Republic of)

Kook-Hwan Oh,

Background

Maintaining residual renal function (RRF) is a crucial issue in peritoneal dialysis (PD). Incremental dialysis is the practice of initiating PD exchanges less than four times a day in consideration of RRF, and increasing dialysis dose step-wisely as the RRF decreases. Effects of incremental PD on the RRF and technique survival have not been widely studied yet.
The aim of this study was to compare the outcomes of incremental PD and full-dose PD in terms of RRF preservation and other outcomes.

Methods

Data were extracted from a retrospective PD cohort (16 years of age or older) who started PD between 2007 and 2015 in the PD Unit of Seoul National University Hospital.
Full-dose PD was defined as a maximal 4 dwell-times per day for continuous ambulatory peritoneal dialysis (CAPD) and as nightly dialysis sessions for automated peritoneal dialysis (APD). Incremental PD was defined as all other PD except full-dose PD.
Outcomes were compared with the use of propensity scores and inverse-probability-weighting (IPW) adjustment to reduce treatment selection bias between incremental and full-dose PD groups. Multivariate time-dependent Cox analyses were performed.

Results

Among 443 included patients, 277 underwent incremental PD and 132 underwent conventional full-dose PD. After IPW adjustment, Incremental PD group exhibited a lower risk of developing anuria (hazard ratio [HR] 0.99; 95% CI, 0.983-0.998). Patient survival, technical survival and peritonitis free survival was similar (Log rank test, P>0.05).

Conclusion

In this observational study, incremental PD was beneficial for preserving residual renal function compared to conventional full-dose PD and showed similar patient survival.

Adjusted, weighted anuria free survival curve