[Infrequent and incremental dialysis: differences and definitions]

G Ital Nefrol. 2018 Feb;35(1):2018-vol1.
[Article in Italian]

Abstract

The purpose of this review is to give dignity at the Incremental Dialysis, which cannot be confused with the term and the therapeutic choice defined as Infrequent Dialysis. The Infrequent Dialysis is defined by each and every hemodialytic therapeutic choice like rhythms below thrice-weekly-hemodialytic treatments. Nonetheless, Infrequent Dialysis is a choice of replacement hemodialysis therapy with pays more special clinical attentions and nutritional monitoring and should also be accompanied by a slightly hypoproteic controlled nutrition. When talking about the Incremental Dialysis (CDDP) it is defined as a well-defined therapeutic program that requires a significant clinical attention. The CDDP begins with the pre-dialysis outpatient clinic in the short period of time when the patient passes, after a severe nutrition compliance assessment with a VFG of 5-10 mL / min / 1.73mq, from the conservative treatment to an hypoproteic diet composed of 0.6g/ Kg / day with or without essential amino acids and hyposaline diet supplemented by One-Weekly Dialysis. The Incremental Dialysis program is strictly tailored on the trend of Residual Renal Function (FRR). CDDP is a time variable therapeutic "bridge" that must provide a good metabolic status and a good quality of life of the treated patients. Recent studies have shown a lower mortality compared with thrice-weekly-dialysis and a neutral input/output balance of phosphorus pool due to the phosphaturia contribution compared to the thrice-weekly-patients who lose early their FRR. Further studies are needed to confirm the safety and validity of this therapeutic choice.

Keywords: Incremental Hemodialysis; Infrequent Hemodialysis; hypoproteic diet.

Publication types

  • Review

MeSH terms

  • Appointments and Schedules
  • Clinical Decision-Making
  • Combined Modality Therapy
  • Diet, Protein-Restricted
  • Humans
  • Kidney Failure, Chronic / diet therapy
  • Kidney Failure, Chronic / physiopathology
  • Kidney Failure, Chronic / therapy
  • Kidney Function Tests
  • Phosphates / urine
  • Quality of Life
  • Renal Dialysis / methods*

Substances

  • Phosphates