학술논문
Incremental peritoneal dialysis: New ideas about an old approach.
Document Type
Editorial
Author
Source
Subject
*PERITONEAL dialysis
*QUALITY of life
*KIDNEY diseases
*HEMODIALYSIS
*HUMAN ecology
*TREATMENT of chronic kidney failure
*KIDNEY function tests
*KIDNEYS
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Language
ISSN
0894-0959
Abstract
Coping with the transition from end-stage kidney disease to dialysis can be challenging for patients and their care partners. Introducing incident dialysis patients to incremental forms of dialysis is associated with better quality of life and reduced cost. Incremental hemodialysis (HD) has generated significant interest over the last decade with treatments that focus on clinical criteria rather than prespecified Kt/Vurea targets. Incremental peritoneal dialysis (PD) has traditionally focused on the sum of residual renal and peritoneal clearances to achieve a specific Kt/Vurea value. Gradual increases in the PD dose were prescribed as the residual kidney function declined. Adopting a new approach to incremental PD similar to what has been done for incremental HD would obviate the need for Kt/Vurea and focus exclusively on clinical criteria. New incremental PD may be considered less disruptive to incident dialysis patients, and may be more likely to be accepted as treatment. It will also reduce our obsession with small solute kinetics and enhance encounters with patients by focusing instead on the holisitc clinical assessment. [ABSTRACT FROM AUTHOR]