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Incremental PD Residual Function — ESENeph MCQ

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ModeratePeritoneal DialysisIncremental PD Residual FunctionESENeph

A 55-year-old man with CKD G5D on PD asks about incremental (assisted) PD. He still has significant residual renal function (urine output 1.5 L/day, renal Kt/V 0.8). What does incremental PD involve?

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Correct answer: C — Starting with a reduced PD prescription (e.g. 1-2 exchanges instead of 4) utilising residual renal function, then gradually increasing the PD dose as residual function declines

Incremental PD starts with a lower intensity prescription that supplements residual renal function rather than replacing it entirely. As residual function declines (monitored by regular clearance measurements), the PD prescription is gradually intensified. ISPD 2020 supports this approach – it preserves residual function longer, reduces glucose exposure, improves quality of life, and avoids overtreatment. The combined (peritoneal + renal) clearance target must still be met. Regular reassessment of residual function is essential.

Reference: ISPD 2020 – Incremental PD Guidelines; UKKA 2017 – PD