Abstract：
OBJECTIVE: Incremental peritoneal dialysis (IPD) could decrease unfavorable glucose exposure results and preserve (RKF). However, there is no standardization of dialysis prescriptions for patients undergoing IPD. We designed a prospective observational multi-center study with a standardized IPD prescription to evaluate the effect of IPD on RKF, metabolic alterations, blood pressure control, and adverse outcomes.
METHODS: All patients used low GDP product (GDP) neutral pH solutions in both the incremental continuous ambulatory peritoneal dialysis (ICAPD) group and the retrospective standard PD (sPD) group. IPD patients started treatment with three daily exchanges five days a week. Control-group patients performed four changes per day, seven days a week.
RESULTS: A total of 94 patients (47 IPD and 47 sPD) were included in this study. The small-solute clearance and mean blood pressures were similar between both groups during follow-up. The weekly mean glucose exposure was significantly higher in sPD group than IPD during the follow-up (p < 0.001). The patients with sPD required more phosphate-binding medications compared to the IPD group (p = 0.05). The rates of peritonitis, tunnel infection, and hospitalization frequencies were similar between groups. Patients in the sPD group experienced more episodes of hypervolemia compared to the IPD group (p = 0.007). The slope in RKF in the 6th month was significantly higher in the sPD group compared to the IPD group (65% vs. 95%, p = 0.001).
CONCLUSIONS: IPD could be a rational dialysis method and provide non-inferior dialysis adequacy compared to full-dose PD. This regimen may contribute to preserving RKF for a longer period.
METHODS: All patients used low GDP product (GDP) neutral pH solutions in both the incremental continuous ambulatory peritoneal dialysis (ICAPD) group and the retrospective standard PD (sPD) group. IPD patients started treatment with three daily exchanges five days a week. Control-group patients performed four changes per day, seven days a week.
RESULTS: A total of 94 patients (47 IPD and 47 sPD) were included in this study. The small-solute clearance and mean blood pressures were similar between both groups during follow-up. The weekly mean glucose exposure was significantly higher in sPD group than IPD during the follow-up (p < 0.001). The patients with sPD required more phosphate-binding medications compared to the IPD group (p = 0.05). The rates of peritonitis, tunnel infection, and hospitalization frequencies were similar between groups. Patients in the sPD group experienced more episodes of hypervolemia compared to the IPD group (p = 0.007). The slope in RKF in the 6th month was significantly higher in the sPD group compared to the IPD group (65% vs. 95%, p = 0.001).
CONCLUSIONS: IPD could be a rational dialysis method and provide non-inferior dialysis adequacy compared to full-dose PD. This regimen may contribute to preserving RKF for a longer period.
摘要：
目的：增量腹膜透析（IPD）可以减少不利的葡萄糖暴露结果并保留（RKF）。然而,IPD患者的透析处方没有标准化.我们设计了一项具有标准化IPD处方的前瞻性观察性多中心研究，以评估IPD对RKF的影响。代谢改变，血压控制,和不良后果。
方法：在增量式连续非卧床腹膜透析（ICPD）组和回顾性标准PD（sPD）组中，所有患者均使用低GDP产品（GDP）中性pH溶液。IPD患者开始治疗，每周5天每天交换三次。对照组患者每天进行四次改变，一周七天.
结果：本研究共纳入94例患者（47例IPD和47例sPD）。随访期间，两组之间的小溶质清除率和平均血压相似。在随访期间，sPD组的每周平均葡萄糖暴露量明显高于IPD（p<0.001）。与IPD组相比，sPD患者需要更多的磷酸盐结合药物（p=0.05）。腹膜炎的发病率,隧道感染,两组住院频率相似.与IPD组相比，sPD组的患者出现了更多的高血容量发作（p=0.007）。与IPD组相比，sPD组第6个月的RKF斜率明显更高（65％vs.95%,p=0.001)。
结论：与全剂量PD相比，IPD可能是一种合理的透析方法，并且透析充分性不差。该方案可能有助于将RKF保留更长的时间。
方法：在增量式连续非卧床腹膜透析（ICPD）组和回顾性标准PD（sPD）组中，所有患者均使用低GDP产品（GDP）中性pH溶液。IPD患者开始治疗，每周5天每天交换三次。对照组患者每天进行四次改变，一周七天.
结果：本研究共纳入94例患者（47例IPD和47例sPD）。随访期间，两组之间的小溶质清除率和平均血压相似。在随访期间，sPD组的每周平均葡萄糖暴露量明显高于IPD（p<0.001）。与IPD组相比，sPD患者需要更多的磷酸盐结合药物（p=0.05）。腹膜炎的发病率,隧道感染,两组住院频率相似.与IPD组相比，sPD组的患者出现了更多的高血容量发作（p=0.007）。与IPD组相比，sPD组第6个月的RKF斜率明显更高（65％vs.95%,p=0.001)。
结论：与全剂量PD相比，IPD可能是一种合理的透析方法，并且透析充分性不差。该方案可能有助于将RKF保留更长的时间。
