Publicação
The role of incremental peritoneal dialysis among patients on peritoneal dialysis. A longitudinal analysis over 20 years
| Resumo: | ABSTRACT Background: There is an ongoing increasing focus on person‑centered individualized dialysis prescription. For this model, incremental peritoneal dialysis has been established as a strategy to start peritoneal dialysis, with an intention to increase the dose of peritoneal dialysis, as a consequence of renal clearance declines. In spite of being broadly accepted, the evidence of non‑inferiority of the incremental approach in comparison with full dose peritoneal dialysis is weak. To disclose the possibility and safety of an incremental approach in incident patients, we assessed patients and technique survival (main outcomes) between incremental and full dose peritoneal dialysis. We also compared the effects in the clinical parameters of adequacy, urinary output and peritonitis incidence in both approaches. Methods: Following a retrospective design, we undertook an observational study in our center over 20 years. We investigated 106 patients divided into two groups, according to initial peritoneal dialysis strategy (incremental or full dose). We used multivariate multinomial model to assess predictors of peritonitis. The main outcomes were studies using a competing risk model. Results: One year after peritoneal dialysis start, our data disclosed statistically significant differences of phosphatemia and solute removal between full dose and incremental approach, favoring the latter. In an incremental approach, two or more peritoneal infections and drop out to hemodialysis were less usual. Conclusions: Incremental peritoneal prescription seems to be a good choice to start peritoneal dialysis. Potential benefits and, above all, safety reinforce the adoption of incremental peritoneal dialysis in incident patients as a strategy of individualized care, in compliance with new guidelines. |
|---|---|
| Autores principais: | Santos,Joana Eugénio |
| Outros Autores: | Silva,Rui; Vicente,Rita; Santos,Iolanda; Coimbra,Miguel; Fiel,David; Amoedo,Manuel; Pires,Carlos |
| Assunto: | incremental peritoneal dialysis peritonitis residual renal function technique survival |
| Ano: | 2021 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Fundação para a Ciência e Tecnologia |
| Idioma: | inglês |
| Origem: | SciELO Portugal |
| _version_ | 1868441695804194816 |
|---|---|
| author | Santos,Joana Eugénio |
| author2 | Silva,Rui Vicente,Rita Santos,Iolanda Coimbra,Miguel Fiel,David Amoedo,Manuel Pires,Carlos |
| author2_role | author author author author author author author |
| author_facet | Santos,Joana Eugénio Silva,Rui Vicente,Rita Santos,Iolanda Coimbra,Miguel Fiel,David Amoedo,Manuel Pires,Carlos |
| author_role | author |
| country_str | PT |
| creators_json_txt | [{\"Person.name\":\"Santos,Joana Eugénio\"},{\"Person.name\":\"Silva,Rui\"},{\"Person.name\":\"Vicente,Rita\"},{\"Person.name\":\"Santos,Iolanda\"},{\"Person.name\":\"Coimbra,Miguel\"},{\"Person.name\":\"Fiel,David\"},{\"Person.name\":\"Amoedo,Manuel\"},{\"Person.name\":\"Pires,Carlos\"}] |
| datacite.creators.creator.creatorName.fl_str_mv | Santos,Joana Eugénio Silva,Rui Vicente,Rita Santos,Iolanda Coimbra,Miguel Fiel,David Amoedo,Manuel Pires,Carlos |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| datacite.subjects.subject.fl_str_mv | incremental peritoneal dialysis peritonitis residual renal function technique survival |
| datacite.titles.title.fl_str_mv | The role of incremental peritoneal dialysis among patients on peritoneal dialysis. A longitudinal analysis over 20 years |
| dc.creator.none.fl_str_mv | Santos,Joana Eugénio Silva,Rui Vicente,Rita Santos,Iolanda Coimbra,Miguel Fiel,David Amoedo,Manuel Pires,Carlos |
| dc.format.none.fl_str_mv | text/html |
| dc.identifier.none.fl_str_mv | http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692021000100022 |
| dc.language.none.fl_str_mv | eng |
| dc.publisher.none.fl_str_mv | Sociedade Portuguesa de Nefrologia |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| dc.source.none.fl_str_mv | Portuguese Journal of Nephrology & Hypertension v.35 n.1 2021 |
| dc.subject.none.fl_str_mv | incremental peritoneal dialysis peritonitis residual renal function technique survival |
| dc.title.fl_str_mv | The role of incremental peritoneal dialysis among patients on peritoneal dialysis. A longitudinal analysis over 20 years |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_6501 |
| description | ABSTRACT Background: There is an ongoing increasing focus on person‑centered individualized dialysis prescription. For this model, incremental peritoneal dialysis has been established as a strategy to start peritoneal dialysis, with an intention to increase the dose of peritoneal dialysis, as a consequence of renal clearance declines. In spite of being broadly accepted, the evidence of non‑inferiority of the incremental approach in comparison with full dose peritoneal dialysis is weak. To disclose the possibility and safety of an incremental approach in incident patients, we assessed patients and technique survival (main outcomes) between incremental and full dose peritoneal dialysis. We also compared the effects in the clinical parameters of adequacy, urinary output and peritonitis incidence in both approaches. Methods: Following a retrospective design, we undertook an observational study in our center over 20 years. We investigated 106 patients divided into two groups, according to initial peritoneal dialysis strategy (incremental or full dose). We used multivariate multinomial model to assess predictors of peritonitis. The main outcomes were studies using a competing risk model. Results: One year after peritoneal dialysis start, our data disclosed statistically significant differences of phosphatemia and solute removal between full dose and incremental approach, favoring the latter. In an incremental approach, two or more peritoneal infections and drop out to hemodialysis were less usual. Conclusions: Incremental peritoneal prescription seems to be a good choice to start peritoneal dialysis. Potential benefits and, above all, safety reinforce the adoption of incremental peritoneal dialysis in incident patients as a strategy of individualized care, in compliance with new guidelines. |
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| eu_rights_str_mv | openAccess |
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| identifier.url.fl_str_mv | http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692021000100022 |
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| institution | Fundação para a Ciência e Tecnologia |
| instname_str | Fundação para a Ciência e Tecnologia |
| language | eng |
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| person_str_mv | Santos,Joana Eugénio Silva,Rui Vicente,Rita Santos,Iolanda Coimbra,Miguel Fiel,David Amoedo,Manuel Pires,Carlos |
| publishDate | 2021 |
| publisher.none.fl_str_mv | Sociedade Portuguesa de Nefrologia |
| reponame_str | SciELO Portugal |
| repository_id_str | urn:repositoryAcronym:scielopt |
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| spelling | The role of incremental peritoneal dialysis among patients on peritoneal dialysis. A longitudinal analysis over 20 yearsSantos,Joana EugénioSilva,RuiVicente,RitaSantos,IolandaCoimbra,MiguelFiel,DavidAmoedo,ManuelPires,Carlosincrementalperitoneal dialysisperitonitisresidual renal functiontechnique survivalopen accesshttp://purl.org/coar/access_right/c_abf2http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692021000100022URLhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692021000100022URLHasVersion2021-03-01ABSTRACT Background: There is an ongoing increasing focus on person‑centered individualized dialysis prescription. For this model, incremental peritoneal dialysis has been established as a strategy to start peritoneal dialysis, with an intention to increase the dose of peritoneal dialysis, as a consequence of renal clearance declines. In spite of being broadly accepted, the evidence of non‑inferiority of the incremental approach in comparison with full dose peritoneal dialysis is weak. To disclose the possibility and safety of an incremental approach in incident patients, we assessed patients and technique survival (main outcomes) between incremental and full dose peritoneal dialysis. We also compared the effects in the clinical parameters of adequacy, urinary output and peritonitis incidence in both approaches. Methods: Following a retrospective design, we undertook an observational study in our center over 20 years. We investigated 106 patients divided into two groups, according to initial peritoneal dialysis strategy (incremental or full dose). We used multivariate multinomial model to assess predictors of peritonitis. The main outcomes were studies using a competing risk model. Results: One year after peritoneal dialysis start, our data disclosed statistically significant differences of phosphatemia and solute removal between full dose and incremental approach, favoring the latter. In an incremental approach, two or more peritoneal infections and drop out to hemodialysis were less usual. Conclusions: Incremental peritoneal prescription seems to be a good choice to start peritoneal dialysis. Potential benefits and, above all, safety reinforce the adoption of incremental peritoneal dialysis in incident patients as a strategy of individualized care, in compliance with new guidelines.Sociedade Portuguesa de NefrologiaPortuguese Journal of Nephrology & Hypertension v.35 n.1 2021text/htmlengjournal articlehttp://purl.org/coar/resource_type/c_6501literature |
| spellingShingle | The role of incremental peritoneal dialysis among patients on peritoneal dialysis. A longitudinal analysis over 20 years Santos,Joana Eugénio incremental peritoneal dialysis peritonitis residual renal function technique survival |
| status | SINGLETON |
| subject.fl_str_mv | incremental peritoneal dialysis peritonitis residual renal function technique survival |
| title | The role of incremental peritoneal dialysis among patients on peritoneal dialysis. A longitudinal analysis over 20 years |
| title_full | The role of incremental peritoneal dialysis among patients on peritoneal dialysis. A longitudinal analysis over 20 years |
| title_fullStr | The role of incremental peritoneal dialysis among patients on peritoneal dialysis. A longitudinal analysis over 20 years |
| title_full_unstemmed | The role of incremental peritoneal dialysis among patients on peritoneal dialysis. A longitudinal analysis over 20 years |
| title_short | The role of incremental peritoneal dialysis among patients on peritoneal dialysis. A longitudinal analysis over 20 years |
| title_sort | The role of incremental peritoneal dialysis among patients on peritoneal dialysis. A longitudinal analysis over 20 years |
| topic | incremental peritoneal dialysis peritonitis residual renal function technique survival |
| topic_facet | incremental peritoneal dialysis peritonitis residual renal function technique survival |
| url | http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692021000100022 |
| visible | 1 |