nach oben

Erschienen in:

01.10.2019 | Original Article

Incremental dialysis in ESRD: systematic review and meta-analysis

verfasst von: Carlo Garofalo, Silvio Borrelli, Toni De Stefano, Michele Provenzano, Michele Andreucci, Gianfranca Cabiddu, Vincenzo La Milia, Valerio Vizzardi, Massimo Sandrini, Giovanni Cancarini, Adamasco Cupisti, Vincenzo Bellizzi, Roberto Russo, Paolo Chiodini, Roberto Minutolo, Giuseppe Conte, Luca De Nicola

Erschienen in: Journal of Nephrology | Ausgabe 5/2019

Einloggen, um Zugang zu erhalten

Abstract

Background

Incremental dialysis may preserve residual renal function and improve survival in comparison with full-dose dialysis; however, available evidence is limited. We therefore compared all-cause mortality and residual kidney function (RKF) loss in incremental and full-dose dialysis and time to full-dose dialysis in incremental hemodialysis (IHD) and incremental peritoneal dialysis (IPD).

Methods

We performed a systematic review and meta-analysis of cohort studies of adults with ESRD starting IHD and IPD. We identified in PubMed and Web of Science database all cohort studies evaluating incremental dialysis evaluating three outcomes: all-cause mortality, RKF loss, time to full dialysis. IPD was defined as < 3 daily dwells in Continuous Ambulatory Peritoneal Dialysis and < 5 sessions per week in Automated Peritoneal Dialysis, while IHD was defined as < 3 HD sessions per week.

Results

22 studies (75,292 participants), 15 in HD and 7 in PD, were analyzed. Mean age at dialysis start was 62 and 57 years in IHD and IPD subjects, respectively. When compared to full dose, incremental dialysis (IHD or IPD) had an overall mortality risk of 1.14 [95% CI 0.85–1.52] with high heterogeneity among studies (I² 86%, P < 0.001), and lower mean RKF loss (− 0.58 ml/min/months, 95% CI 0.16–1.01, P = 0.007). Overall, time to full-dose dialysis was 12.1 months (95% CI 9.8–14.3) with no difference between IHD and IPD (P = 0.217).

Conclusions

Incremental dialysis allows longer preservation of RKF thus deferring full-dose dialysis, by about 1 year in HD and PD, with no increase in mortality risk. Large and adequate studies are needed to confirm these findings.

Nur mit Berechtigung zugänglich

Pacilio M, Minutolo R, Garofalo C, Liberti ME, Conte G, De Nicola L (2016) Stage 5-CKD under nephrology care: to dialyze or not to dialyze, that is the question. J Nephrol 29(2):153–161CrossRefPubMed

United States Renal Data System (2015) USRDS annual data report: Epidemiology of kidney disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda

ERA-EDTA Registry: ERA-EDTA Registry Annual Report (2013) Academic Medical Center. Department of Medical Informatics, Amsterdam

Thomas B, Wulf S, Bikbov B et al (2015) Maintenance dialysis throughout the World in Years 1990 and 2010. J Am Soc Nephrol 26(11):2621–2633CrossRefPubMedPubMedCentral

Vanholder R, Lameire N, Annemans L, Van Biesen W (2016) Cost of renal replacement: how to help as many as possible while keeping expenses reasonable? Nephrol Dial Transpl 31(8):1251–1261CrossRef

Eckardt K, Gillespie I, Kronenberg F et al (2015) High cardiovascular event rates occur within the first weeks of starting hemodialysis. Kidney Int 88(5):1117–1125CrossRefPubMedPubMedCentral

Zareba W (2015) Initiation of dialysis: trigger or cause of cardiovascular events? Kidney Int 88(5):942–944CrossRefPubMed

Selby NM, Lambie SH, Camici PG, Baker CS, McIntyre CW (2006) Occurrence of regional left ventricular dysfunction in patients undergoing standard and biofeedback dialysis. Am J Kidney Dis 47(5):830–841CrossRefPubMed

McIntyre CW, Burton JO, Selby NM et al (2008) Hemodialysis-induced cardiac dysfunction is associated with an acute reduction in global and segmental myocardial blood flow. Clin J Am Soc Nephrol 3(1):19–26CrossRefPubMedPubMedCentral

10.

Burton JO, Jefferies HJ, Selby NM, McIntyre CW (2009) Hemodialysis-induced repetitive myocardial injury results in global and segmental reduction in systolic cardiac function. Clin J Am Soc Nephrol 4(12):1925–1931CrossRefPubMedPubMedCentral

11.

McIntyre CW (2010) Haemodialysis-induced myocardial stunning in chronic kidney disease—a new aspect of cardiovascular disease. Blood Purif 292:105–110CrossRef

12.

Quinn RR, Hux JE, Oliver MJ et al (2011) Selection bias explains apparent differential mortality between dialysis modalities. J Am Soc Nephrol 22(8):1534–1542CrossRefPubMedPubMedCentral

13.

Yeates K, Zhu N, Vonesh E et al (2012) Hemodialysis and peritoneal dialysis are associated with similar outcomes for end-stage renal disease treatment in Canada. Nephrol Dial Transpl 27(9):3568–3575CrossRef

14.

Mehrotra R, Chiu YW, Kalantar-Zadeh K et al (2011) Similar outcomes with hemodialysis and peritoneal dialysis in patients with end-stage renal disease. Arch Intern Med 171(2):110–118CrossRefPubMed

15.

Kumar VA, Sidell MA, Jones JP, Vonesh EF (2014) Survival of propensity matched incident peritoneal and hemodialysis patients in a United States health care system. Kidney Int 86(5):1016–1022CrossRefPubMed

16.

Basile C, Casino FG, Kalantar-Zadeh K (2017) Is incremental hemodialysis ready to return on the scene? From empiricism to kinetic modelling. J Nephrol 30(4):521–529CrossRefPubMed

17.

Kalantar-Zadeh K, Crowley ST, Beddhu S et al (2017) Renal replacement therapy and incremental hemodialysis for veterans with advanced chronic kidney disease. Semin Dial 30(3):251–261CrossRefPubMedPubMedCentral

18.

Teitelbaum I (2018) Crafting the prescription for patients starting peritoneal dialysis. Clin J Am Soc Nephrol 13(3):483–485CrossRefPubMedPubMedCentral

19.

Kalantar-Zadeh K, Kovesdy CP, Streja E et al (2017) Transition of care from pre-dialysis prelude to renal replacement therapy: the blueprints of emerging research in advanced chronic kidney disease. Nephrol Dial Transpl 32(suppl_2):ii91–ii98CrossRef

20.

Wang M, Obi Y, Streja E et al (2018) Impact of residual kidney function on hemodialysis adequacy and patient survival. Nephrol Dial Transpl. https://doi.org/10.1093/ndt/gfy060 CrossRef

21.

Green JPHS (2011) Cochrane handbook for systematic reviews of interventions. http://www.cochrane.org/training/cochrane-handbook. Accessed 9 Apr 2016

22.

Stroup DF, Berlin JA, Morton SC et al (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of Observational Studies in Epidemiology (MOOSE) group. JAMA 283(15):2008–2012CrossRefPubMed

23.

Wells G, Shea B, O’Connell D et al (2017) The Newcastle–Ottawa Scale (NOS) for assessing the quality of non randomized studies in meta-analyses. Ottawa Health Research Institute. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Accessed 13 May 2017

24.

Higgins JP, Altman DG, Gøtzsche PC et al (2011) The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 343:d5928. https://doi.org/10.1136/bmj.d5928 CrossRefPubMedPubMedCentral

25.

Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327(7414):557–560CrossRefPubMedPubMedCentral

26.

Tobias A (1999) Assessing the influence of a single study in the meta-analysis estimate. Stata Tech Bull 8(47):15–17

27.

Van Houwelingen HC, Arends LR, Stijnen T (2002) Advanced methods in meta-analysis: multivariate approach and meta-regression. Stat Med 21(4):589–624CrossRefPubMed

28.

Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50(4):1088–1101CrossRefPubMed

29.

Fernández-Lucas M, Teruel-Briones JL, Gomis-Couto A, Villacorta-Pérez J, Quereda-Rodríguez-Navarro C (2012) Maintaining residual renal function in patients on haemodialysis: 5-year experience using a progressively increasing dialysis regimen. Nefrologia 32(6):767–776PubMed

30.

Mathew A, Obi Y, Rhee CM et al (2016) Treatment frequency and mortality among incident hemodialysis patients in the United States comparing incremental with standard and more frequent dialysis. Kidney Int 90(5):1071–1079CrossRefPubMed

31.

Merino JL, Domínguez P, Bueno B, Amézquita Y, Espejo B, Paraíso V (2017) Application of a pattern of incremental haemodialysis, based on residual renal function, when starting renal replacement therapy. Nefrologia 37(1):39–46CrossRefPubMed

32.

Ghahremani-Ghajar M, Rojas-Bautista V, Lau WL et al (2017) Incremental hemodialysis: the University of California Irvine experience. Semin Dial 30(3):262–269CrossRefPubMedPubMedCentral

33.

Hanson JA, Hulbert-Shearon TE, Ojo AO et al (1999) Prescription of twice-weekly hemodialysis in the USA. Am J Nephrol 19(6):625–633CrossRefPubMed

34.

Stankuvienė A, Ziginskienė E, Kuzminskis V, Bumblytė IA (2010) Impact of hemodialysis dose and frequency on survival of patients on chronic hemodialysis in Lithuania during 1998–2005. Medicina (Kaunas) 46(8):516–521CrossRef

35.

Lin X, Yan Y, Ni Z et al (2012) Clinical outcome of twice-weekly hemodialysis patients in shanghai. Blood Purif 33(1–3):66–72CrossRefPubMed

36.

Elamin S, Abu-Aisha H (2012) Reaching target hemoglobin level and having a functioning arteriovenous fistula significantly improve one year survival in twice weekly hemodialysis. Arab J Nephrol Transpl 5(2):81–86

37.

Caria S, Cupisti A, Sau G, Bolasco P (2014) The incremental treatment of ESRD: a low-protein diet combined with weekly hemodialysis may be beneficial for selected patients. BMC Nephrol 15:172CrossRefPubMedPubMedCentral

38.

Hwang HS, Hong YA, Yoon HE et al (2016) Comparison of clinical outcome between twice-weekly and thrice-weekly hemodialysis in patients with residual kidney function. Medicine (Baltimore) 95(7):e2767CrossRef

39.

Park JI, Park JT, Kim YL et al (2017) Comparison of outcomes between the incremental and thrice-weekly initiation of hemodialysis: a propensity-matched study of a prospective cohort in Korea. Nephrol Dial Transpl 32(2):355–363

40.

Obi Y, Streja E, Rhee CM et al (2016) incremental hemodialysis, residual kidney function, and mortality risk in incident dialysis patients: a cohort study. Am J Kidney Dis 68(2):256–265CrossRefPubMedPubMedCentral

41.

Lin YF, Huang JW, Wu MS et al (2009) Comparison of residual renal function in patients undergoing twice-weekly versus three-times-weekly haemodialysis. Nephrology (Carlton) 14(1):59–64CrossRef

42.

Panaput T, Thinkhamrop B, Domrongkitchaiporn S et al (2014) Dialysis dose and risk factors for death among ESRD patients treated with twice-weekly hemodialysis: a prospective cohort study. Blood Purif 38(3–4):253–262CrossRefPubMed

43.

Mukherjee T, Devi G, Geetha S, Anchan NJ, Sankarasubbaiyan S (2017) A comparison of practice pattern and outcome of twice-weekly and thrice-weekly hemodialysis patients. Indian J Nephrol 27(3):185–189CrossRefPubMedPubMedCentral

44.

Williams PF (1999) Timely initiation of dialysis. Am J Kidney Dis 34(3):594–595CrossRefPubMed

45.

De Vecchi AF, Scalamogna A, Finazzi S, Colucci P, Ponticelli C (2000) Preliminary evaluation of incremental peritoneal dialysis in 25 patients. Perit Dial Int 20(4):412–417PubMed

46.

Neri L, Viglino G, Cappelletti A, Gandolfo C, Barbieri S (2003) Incremental dialysis with automated peritoneal dialysis. Adv Perit Dial 19:93–96PubMed

47.

Viglino G, Neri L, Barbieri S (2008) Incremental peritoneal dialysis: effects on the choice of dialysis modality, residual renal function and adequacy. Kidney Int Suppl. https://doi.org/10.1038/sj.ki.5002601 CrossRefPubMed

48.

Jeloka T, Sanwaria P, Chaudhari L, Periera A (2013) “Ico-Alone” single nocturnal exchange to initiate peritoneal dialysis in patients with residual renal function-Five year, single centre experience. Indian J Nephrol 23(4):276–279CrossRefPubMedPubMedCentral

49.

Sandrini M, Vizzardi V, Valerio F et al (2016) Incremental peritoneal dialysis: a 10 year single-centre experience. J Nephrol 29(6):871–879CrossRefPubMedPubMedCentral

50.

Domenici A, Comunian MC, Fazzari L et al (2011) Incremental peritoneal dialysis favourably compares with hemodialysis as a bridge to renal transplantation. Int J Nephrol 2011:204216. https://doi.org/10.4061/2011/204216 CrossRefPubMedPubMedCentral

51.

Kalantar-Zadeh K, Unruh M, Zager PG et al (2014) Twice-weekly and incremental hemodialysis treatment for initiation of kidney replacement therapy. Am J Kidney Dis 64(2):181–186CrossRefPubMedPubMedCentral

52.

Morelli E, Baldi R, Barsotti G et al (1987) Combined therapy for selected chronic uremic patients: infrequent hemodialysis and nutritional management. Nephron 47(3):161–166CrossRefPubMed

53.

Locatelli F, Andrulli S, Pontoriero G, Di Filippo S, Bigi MC (1994) Supplemented low-protein diet and once weekly hemodialysis. Am J Kidney Dis 24(2):192–204CrossRefPubMed

54.

Penne EL, van der Weerd NC, Blankestijn PJ et al (2010) Role of residual kidney function and convective volume on change in beta2-microglobulin levels in hemodiafiltration patients. Clin J Am Soc Nephrol 5(1):80–86CrossRefPubMedPubMedCentral

55.

Fry AC, Singh DK, Chandna SM, Farrington K (2007) Relative importance of residual renal function and convection in determining beta-2-microglobulin levels in high-flux haemodialysis and on-line haemodiafiltration. Blood Purif 25(3):295–302CrossRefPubMed

56.

Gerhardt T, Pöge U, Stoffel-Wagner B et al (2008) Serum levels of beta-trace protein and its association to diuresis in haemodialysis patients. Nephrol Dial Transpl 23(1):309–314CrossRef

57.

Krediet RT (2006) How to preserve residual renal function in patients with chronic kidney disease and on dialysis? Nephrol Dial Transpl 21(Suppl 2):ii42–ii46CrossRef

58.

Yang PY, Lin JL, Lin-Tan DT et al (2009) Residual daily urine volume association with inflammation and nutrition status in maintenance hemodialysis patients. Ren Fail 31(6):423–430CrossRefPubMed

59.

Tian JP, Du FH, Cheng LT, Wang T (2009) Residual renal function and arterial stiffness mediated the blood pressure change during interdialytic weight gain in hemodialysis patients. Hemodial Int 13(4):479–486CrossRefPubMed

60.

Borrelli S, Leonardis D, Minutolo R et al (2015) Epidemiology of CKD regression in patients under nephrology care. PLoS One. https://doi.org/10.1371/journal.pone.0140138.e CrossRefPubMedPubMedCentral

61.

Golper TA, Mehrotra R (2015) The intact nephron hypothesis in reverse: an argument to support incremental dialysis. Nephrol Dial Transpl 30(10):1602–1604CrossRef

62.

Roggeri A, Roggeri DP, Zocchetti C, Bersani M, Conte F (2017) ReNe (Renal Lombardy Network); additional contributors from ReNe Network. Healthcare costs of the progression of chronic kidney disease and different dialysis techniques estimated through administrative database analysis. J Nephrol 30(2):263–269CrossRefPubMed

63.

Bolasco P, Cupisti A, Locatelli F, Caria S, Kalantar-Zadeh K (2016) Dietary management of incremental transition to dialysis therapy: once-weekly hemodialysis combined with low-protein diet. J Ren Nutr 26(6):352–359CrossRefPubMed

64.

Mathew AT, Obi Y, Rhee CM, Chou JA, Kalantar-Zadeh K (2018) Incremental dialysis for preserving residual kidney function-Does one size fit all when initiating dialysis? Semin Dial 31(4):343–352CrossRefPubMedPubMedCentral

Titel: Incremental dialysis in ESRD: systematic review and meta-analysis
verfasst von: Carlo Garofalo
Silvio Borrelli
Toni De Stefano
Michele Provenzano
Michele Andreucci
Gianfranca Cabiddu
Vincenzo La Milia
Valerio Vizzardi
Massimo Sandrini
Giovanni Cancarini
Adamasco Cupisti
Vincenzo Bellizzi
Roberto Russo
Paolo Chiodini
Roberto Minutolo
Giuseppe Conte
Luca De Nicola
Publikationsdatum: 01.10.2019
Verlag: Springer International Publishing
Erschienen in: Journal of Nephrology / Ausgabe 5/2019
Print ISSN: 1121-8428
Elektronische ISSN: 1724-6059
DOI: https://doi.org/10.1007/s40620-018-00577-9

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Mehr Lebenszeit mit Abemaciclib bei fortgeschrittenem Brustkrebs?

24.05.2024 Mammakarzinom Nachrichten

In der MONARCHE-3-Studie lebten Frauen mit fortgeschrittenem Hormonrezeptor-positivem, HER2-negativem Brustkrebs länger, wenn sie zusätzlich zu einem nicht steroidalen Aromatasehemmer mit Abemaciclib behandelt wurden; allerdings verfehlte der numerische Zugewinn die statistische Signifikanz.

ADT zur Radiatio nach Prostatektomie: Wenn, dann wohl länger

24.05.2024 Prostatakarzinom Nachrichten

Welchen Nutzen es trägt, wenn die Strahlentherapie nach radikaler Prostatektomie um eine Androgendeprivation ergänzt wird, hat die RADICALS-HD-Studie untersucht. Nun liegen die Ergebnisse vor. Sie sprechen für länger dauernden Hormonentzug.

„Überwältigende“ Evidenz für Tripeltherapie beim metastasierten Prostata-Ca.

22.05.2024 Prostatakarzinom Nachrichten

Patienten mit metastasiertem hormonsensitivem Prostatakarzinom sollten nicht mehr mit einer alleinigen Androgendeprivationstherapie (ADT) behandelt werden, mahnt ein US-Team nach Sichtung der aktuellen Datenlage. Mit einer Tripeltherapie haben die Betroffenen offenbar die besten Überlebenschancen.

So sicher sind Tattoos: Neue Daten zur Risikobewertung

22.05.2024 Melanom Nachrichten

Das größte medizinische Problem bei Tattoos bleiben allergische Reaktionen. Melanome werden dadurch offensichtlich nicht gefördert, die Farbpigmente könnten aber andere Tumoren begünstigen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Abstract

Background

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 5/2019

Catheter-related infections in peritoneal dialysis: comparison of a single center results and the literature data

Correction to: Role of anemia and proteinuria in the development of subsequent renal function deterioration in a general population with preserved glomerular filtration rate: a community-based cohort study

The relationship between the concentration of plasma homocysteine and chronic kidney disease: a cross sectional study of a large cohort

Interferon-free regimens improve kidney function in patients with chronic hepatitis C infection

Homocysteine and chronic kidney disease: an ongoing narrative