Association of Incremental peritoneal dialysis with residual kidney function decline in patients on peritoneal dialysis: The balANZ trial.

Anuria disease progression full-dose dialysis glomerular filtration rate glucose degradation products incremental dialysis kidney function tests outcomes peritoneal dialysis preservation prospective studies randomised controlled studies residual kidney function risk factors time factors treatment outcome urine volume

Journal

Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis
ISSN: 1718-4304
Titre abrégé: Perit Dial Int
Pays: United States
ID NLM: 8904033

Informations de publication

Date de publication:
09 2023
Historique:
medline: 8 9 2023
pubmed: 1 6 2023
entrez: 1 6 2023
Statut: ppublish

Résumé

Incremental peritoneal dialysis (PD), defined as less than Full-dose PD prescription, has several possible merits, including better preservation of residual kidney function (RKF), lower peritoneal glucose exposure and reduced risk of peritonitis. The aims of this study were to analyse the association of Incremental and Full-dose PD strategy with RKF and urine volume (UV) decline in patients commencing PD. Incident PD patients who participated in the balANZ randomised controlled trial (RCT) (2004-2010) and had at least one post-baseline RKF and UV measurement was included in this study. Patients receiving <56 L/week and ≥56 L/week of PD fluid at PD commencement were classified as Incremental and Full-dose PD, respectively. An alternative cut-point of 42 L/week was used in a sensitivity analysis. The primary and secondary outcomes were changes in measured RKF and daily UV, respectively. The study included 154 patients (mean age 57.9 ± 14.1 years, 44% female, 34% diabetic, mean follow-up 19.5 ± 6.6 months). Incremental and Full-dose PD was commenced by 45 (29.2%) and 109 (70.8%) participants, respectively. RKF declined in the Incremental group from 7.9 ± 3.2 mL/min/1.73 m Compared with Full-dose PD start, Incremental PD start is associated with similar declines in RKF and UV.

Sections du résumé

BACKGROUND
Incremental peritoneal dialysis (PD), defined as less than Full-dose PD prescription, has several possible merits, including better preservation of residual kidney function (RKF), lower peritoneal glucose exposure and reduced risk of peritonitis. The aims of this study were to analyse the association of Incremental and Full-dose PD strategy with RKF and urine volume (UV) decline in patients commencing PD.
METHODS
Incident PD patients who participated in the balANZ randomised controlled trial (RCT) (2004-2010) and had at least one post-baseline RKF and UV measurement was included in this study. Patients receiving <56 L/week and ≥56 L/week of PD fluid at PD commencement were classified as Incremental and Full-dose PD, respectively. An alternative cut-point of 42 L/week was used in a sensitivity analysis. The primary and secondary outcomes were changes in measured RKF and daily UV, respectively.
RESULTS
The study included 154 patients (mean age 57.9 ± 14.1 years, 44% female, 34% diabetic, mean follow-up 19.5 ± 6.6 months). Incremental and Full-dose PD was commenced by 45 (29.2%) and 109 (70.8%) participants, respectively. RKF declined in the Incremental group from 7.9 ± 3.2 mL/min/1.73 m
CONCLUSIONS
Compared with Full-dose PD start, Incremental PD start is associated with similar declines in RKF and UV.

Identifiants

pubmed: 37259236
doi: 10.1177/08968608231175826
doi:

Substances chimiques

Dialysis Solutions 0

Types de publication

Randomized Controlled Trial Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

374-382

Auteurs

Ashik Hayat (A)

Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Australia.
Australasian Kidney Trials Network, The University of Queensland, Brisbane, Australia.
Translational Research Institute, Brisbane, Australia.

Yeoungjee Cho (Y)

Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Australia.
Australasian Kidney Trials Network, The University of Queensland, Brisbane, Australia.
Translational Research Institute, Brisbane, Australia.

Carmel M Hawley (CM)

Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Australia.
Australasian Kidney Trials Network, The University of Queensland, Brisbane, Australia.
Translational Research Institute, Brisbane, Australia.

Htay Htay (H)

Department of Renal Medicine, Singapore General Hospital, Singapore.

Rathika Krishnasamy (R)

Australasian Kidney Trials Network, The University of Queensland, Brisbane, Australia.
Sunshine Coast University Hospital, Queensland, Australia.

Elaine Pascoe (E)

Australasian Kidney Trials Network, The University of Queensland, Brisbane, Australia.

Isaac Teitelbaum (I)

Division of Nephrology, Department of Medicine, University of Colorado, Aurora, USA.

Marliene Varnfield (M)

Australasian Kidney Trials Network, The University of Queensland, Brisbane, Australia.
Australian e-Health Research Centre, CSIRO, Brisbane, Australia.

David W Johnson (DW)

Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Australia.
Australasian Kidney Trials Network, The University of Queensland, Brisbane, Australia.
Translational Research Institute, Brisbane, Australia.

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