Vol.:(0123456789) 1 3 J Nephrol DOI 10.1007/s40620-017-0403-0 ORIGINAL ARTICLE Incremental start to PD as experienced in Italy: results of censuses carried out from 2005 to 2014 Loris Neri 1  · Giusto Viglino 1  · Giancarlo Marinangeli 2  · Anna Rachele Rocca 3  · Alessandro Laudon 4  · Antonino Ragusa 5  · Gianfranca Cabiddu 6  · On behalf of Peritoneal Dialysis Study Group of Italian Society of Nephrology Received: 7 February 2017 / Accepted: 10 April 2017 © Italian Society of Nephrology 2017 in general. The most widely-used modality in Incr-PD was CAPD. Conclusions Incr-PD is used in Italy in a large number of incident PD patients. The reasons for this increase need to be clarifed, as current adequacy targets are based on full-dose studies with a very low glomerular fltration rate (GFR). Keywords Peritoneal dialysis · Dialysis adequacy · Incremental dialysis · Residual renal function · Dialysis modality · Dialysis selection Background An incremental start to peritoneal dialysis (PD) (Incr-PD), defned as gradually increasing the dialysis dose as the residual renal function (RRF) declines so as to maintain total clearance (renal and dialysis) constantly at a target Abstract Background It is not known how widely used in Italy an incremental start to in peritoneal dialysis (Incr-PD) is. Methods By analyzing the peritoneal dialysis (PD) cen- suses conducted by the PD Study Group (GSDP-SIN) for the years 2005, 2008, 2010, 2012 and 2014 in all the Cent- ers performing PD in Italy, the use of Incr-PD, i.e. con- tinuous ambulatory peritoneal dialysis (CAPD) with 1 or 2 exchanges/day or automated peritoneal dialysis (APD) with 3–4 sessions/week, was examined among incident PD patients. Results In 2014 PD was started in Italy by 1,652 patients, 455 (27.5%) of whom incrementally (Incr-CAPD 82.2% vs. Incr-APD 17.8%). Incr-PD was used in 53.5% of the 225 Centers. The number of patients and of Centers using Incr-DP increased constantly over the years up to 2012 (in 2005 Incr-PD was used in 33.4% of Centers, and in 11.9% of patients). The use of Incr-PD was greater in Centers with a more extensive PD program and greater use of PD * Loris Neri lorisneri1960@gmail.com Giusto Viglino giustoviglino@gmail.com Giancarlo Marinangeli gcmarinangeli@gmail.com Anna Rachele Rocca racheleroc@gmail.com Alessandro Laudon alelaudon@katamail.com Antonino Ragusa ninoragusa@gmail.com Gianfranca Cabiddu gianfranca.cabiddu@tin.it 1 Nefrologia, Dialisi e Nutrizione Clinica, Ospedale San Lazzaro, Via Pierino Belli 26Alba, Cuneo, Italy 2 Nefrologia e Dialisi, Ospedale Maria SS dello Splendore, Giulianova, Teramo, Italy 3 Nefrologia e Dialisi, Policlinico Umberto I, Roma, Italy 4 Nefrologia e Dialisi, Azienda Provinciale Servizi Sanitari, Trento, Italy 5 Nefrologia e Dialisi, Ospedale San Vincenzo, Taormina, Italy 6 Nefrologia e Dialisi, Azienda Ospedaliera Brotzu, Cagliari, Italy