Hong Kong Journal of Nephrology
Volume 7, Issue 2 , Pages 59-64, October 2005

Worldwide Experience with Incremental Peritoneal Dialysis

  • Michael V. Rocco

      Affiliations

    • Corresponding Author InformationAddress correspondence and reprint requests to: Dr. Michael V. Rocco, Wake Forest University School of Medicine, Department of Internal Medicine, Section on Nephrology, Medical Center Boulevard, Winston-Salem, North Carolina, USA 27157-1053. Fax: (+1) 336-716-4318

Wake Forest University School of Medicine, Department of Internal Medicine, Section on Nephrology, North Carolina, USA

Article Outline

Although much has been published about the adequacy of dialysis and the effect of dialysis dose on morbidity and mortality in peritoneal dialysis patients, much less is known about when dialysis should be initiated. There are several advantages of using peritoneal dialysis for “early start” dialysis compared to hemodialysis, including lifestyle, diet and cost benefits. Several small studies on incremental peritoneal dialysis are reviewed in this article, and they provide conflicting results with regard to patient morbidity and mortality. In addition, there are peritoneal dialysis-related risks to incremental dialysis, including peritonitis, hernias and catheter-related complications. Since none of these studies were performed using a randomized cohort, it is unclear how selection bias and study design may have influenced the results reported. A large randomized trial of “early start” versus “standard start” dialysis is needed to help determine the potential risks and benefits of incremental peritoneal dialysis. Such a study is presently underway in Australia and New Zealand, and results from this study should be available in 2008.

Key words:  early start dialysis , hospitalizations , incremental dialysis , mortality , peritoneal dialysis , peritonitis

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PII: S1561-5413(09)60215-5

doi:10.1016/S1561-5413(09)60215-5

Hong Kong Journal of Nephrology
Volume 7, Issue 2 , Pages 59-64, October 2005

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