{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T07:18:00Z","timestamp":1793085480656,"version":"4.5.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T00:00:00Z","timestamp":1663632000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T00:00:00Z","timestamp":1663632000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T00:00:00Z","timestamp":1663632000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Incremental peritoneal dialysis (incPD) as the initial PD strategy represents a convenient and resource-sparing approach, but its impact on patient, healthcare and environment has not been thoroughly evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study includes 147 patients who started incPD at our institution between 1st January, 2009 and 31st December, 2021. Adequacy measures, peritoneal permeability parameters, peritonitis episodes, hospitalizations and increase in CAPD dose prescriptions were recorded. The savings related to cost, patient glucose exposure, time needed to perform dialysis, plastic waste, and water usage were compared to full-dose PD treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During the study follow-up 11.9% of the patients transitioned from incremental to full dose PD. Patient cumulative probability of remaining on PD at 12, 24, 36, 48 and 60\u00a0months was 87.6, 65.4, 46.1, 30.1 and 17.5%, respectively. The median transition time from 1 to 2 exchanges, from 2 to 3 and 3 to 4 exchanges were 5, 9 and 11.8\u00a0months, respectively. Compared to full dose PD, 1, 2, and 3 exchanges per day led to reduction in glucose exposure of 20.4, 14.8 or 8.3\u00a0kg\/patient-year, free lifetime gain of 18.1, 13.1 or 7.4\u00a0day\/patient-year, a decrease in cost of 8700, 6300 or 3540 \u20ac\/patient-year, a reduction in plastic waste of 139.2, 100.8 or 56.6\u00a0kg\/patient-year, and a decline in water use of 25,056, 18,144 or 10,196 L\/patient-year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In comparison with full-dose PD, incPD allows to reduce the time spent for managing\u00a0dialysis, glucose exposure, economic cost, plastic waste, and water consumption.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s40620-022-01433-7","type":"journal-article","created":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T05:04:03Z","timestamp":1663650243000},"page":"263-273","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Incremental peritoneal dialysis allows to reduce the time spent for dialysis, glucose exposure, economic cost, plastic waste and water consumption"],"prefix":"10.1093","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1749-7100","authenticated-orcid":false,"given":"Luca","family":"Nardelli","sequence":"first","affiliation":[{"name":"Division of Nephrology, Dialysis and Kidney Transplantation, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, Via della Commenda 15, 20122, Milan, Italy 1"},{"name":"Department of Clinical Sciences and Community Health, Universit\u00e0 degli studi di Milano, Milan, Italy 2"},{"name":"Division of Nephrology and 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June 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 August 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 September 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"We have read and understood\u00a0Journal of Nephrology's policy on disclosing conflicts of interest and declare that we have none.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicting interest"}},{"value":"None.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"Not required (retrospective cohort study undertaken through a case note review).","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not required.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent to participate"}},{"value":"No doubt that anonymity can be maintained.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent to publish"}},{"value":"Research idea and study design: LN, AS; data acquisition: LN, EC; data analysis\/interpretation: LN, AS; statistical analysis: LN; supervision or mentorship: GC. Each author contributed important intellectual content during manuscript drafting or revision and accepts accountability for the overall work by ensuring that questions pertaining to the accuracy or integrity of any portion of the work are appropriately investigated and resolved.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Authorship"}}]}}