{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T01:07:25Z","timestamp":1790816845606,"version":"4.1.0"},"reference-count":26,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perit Dial Int"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The impact of incremental peritoneal dialysis (PD) on outcomes is poorly understood, and there is a paucity of evidence informing best practices regarding the dialysis dose at the commencement of PD. This international prospective cohort study aimed to compare PD prescription practices at dialysis commencement and their subsequent association with clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adult patients who started PD for less than three months at the time of enrolment in the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) between 1 January 2014 and 31 December 2017 were included. Patients were defined as initiating incremental PD if prescribed a total of &lt;4 exchanges\/day for continuous ambulatory peritoneal dialysis (CAPD) or, with dry days or having PD less than seven days per week for automated peritoneal dialysis (APD). All other prescriptions were considered standard PD. The primary outcome was the transfer to haemodialysis (HD). Secondary outcomes included peritonitis rate, time to first peritonitis and mortality. Logistic regression analysed PD uptake and the Cox proportional hazards regression model analysed HD transfer, peritonitis and patient survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 1365 PD patients from 128 facilities across seven countries were included. Fewer individuals started on incremental PD than standard PD (37% vs 63%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Higher incremental PD uptake was associated with receiving treatment in Japan (odds ratio [OR] 2.35, 95% CI 1.05\u20135.26,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.04; ref: Canada), age &gt;75 years (OR 1.51, 95% CI 1.02\u20132.24,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.04), icodextrin use (OR 8.54, 95% CI 6.26\u201311.64,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), lower serum creatinine concentration at PD start (OR 1.01, 95% CI 1.01\u20131.01,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.007) and higher number of PD patients at a facility (OR 1.01, 95% CI 1.00\u20131.01,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.02). Crude HD transfer rates for the incremental and standard PD groups were 0.14 (95% CI, 0.12\u20130.16) and 0.15 (95% CI, 0.13\u20130.17) per patient-year of follow-up, respectively (incidence rate ratio [IRR], 0.93; 95% CI, 0.75\u20131.15;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.49). There was no significant difference in the hazard of HD transfer between the incremental and standard PD groups (hazard ratio [HR] 0.87, 95% CI 0.68\u20131.12,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.29). There were also no differences between the two groups concerning peritonitis and mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Incremental PD start was prescribed in approximately one-third of patients and, in low certainty evidence, was associated with comparable risks of HD transfer, peritonitis and death.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08968608251385614","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T16:59:28Z","timestamp":1761584368000},"page":"163-173","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Incremental start and clinical outcomes in peritoneal dialysis: International results from PDOPPS"],"prefix":"10.1177","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3543-4047","authenticated-orcid":false,"given":"Ashik","family":"Hayat","sequence":"first","affiliation":[{"name":"Princess Alexandra Hospital"},{"name":"Australasian Kidney Trials Network, University of Queensland, Brisbane, Australia"},{"name":"Translational Research Institute, Brisbane, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa S","family":"Cheetham","sequence":"additional","affiliation":[{"name":"Sunshine Coast University Hospital"},{"name":"Faculty of Medicine, University of Queensland, Brisbane, Australia"},{"name":"Sunshine Coast Health Institute, Birtinya, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3502-9837","authenticated-orcid":false,"given":"Yeoungjee","family":"Cho","sequence":"additional","affiliation":[{"name":"Princess Alexandra Hospital"},{"name":"Australasian Kidney Trials Network, University of Queensland, Brisbane, Australia"},{"name":"Translational Research Institute, Brisbane, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junhui","family":"Zhao","sequence":"additional","affiliation":[{"name":"Arbor Research Collaborative for Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1995-1888","authenticated-orcid":false,"given":"Keith","family":"McCullough","sequence":"additional","affiliation":[{"name":"Arbor Research Collaborative for Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas S","family":"Fuller","sequence":"additional","affiliation":[{"name":"Arbor Research Collaborative for Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rathika","family":"Krishnasamy","sequence":"additional","affiliation":[{"name":"Sunshine Coast University Hospital"},{"name":"Faculty of Medicine, University of Queensland, Brisbane, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5884-640X","authenticated-orcid":false,"given":"Neil","family":"Boudville","sequence":"additional","affiliation":[{"name":"Sir Charles Gairdner Hospital, Perth, Australia"},{"name":"Medical School, University of Western Australia, Perth, \rAustralia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8555-8649","authenticated-orcid":false,"given":"Ana E","family":"Figueiredo","sequence":"additional","affiliation":[{"name":"Pontificia Universidade Cat\u00f3lica do Rio Grande do Sul"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiko","family":"Ito","sequence":"additional","affiliation":[{"name":"Aichi Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2996-8934","authenticated-orcid":false,"given":"Talerngsak","family":"Kanjanabuch","sequence":"additional","affiliation":[{"name":"Chulalongkorn University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Perl","sequence":"additional","affiliation":[{"name":"Arbor Research Collaborative for Health"},{"name":"St Michael's Hospital, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth M","family":"Piraino","sequence":"additional","affiliation":[{"name":"University of Pittsburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald L","family":"Pisoni","sequence":"additional","affiliation":[{"name":"Arbor Research Collaborative for Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8898-8505","authenticated-orcid":false,"given":"Cheuk C","family":"Szeto","sequence":"additional","affiliation":[{"name":"The Chinese University of Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7526-6837","authenticated-orcid":false,"given":"Isaac","family":"Teitelbaum","sequence":"additional","affiliation":[{"name":"University of Colorado, Aurora, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham","family":"Woodrow","sequence":"additional","affiliation":[{"name":"Renal Unit, St James's University Hospital, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Tsuchiya","sequence":"additional","affiliation":[{"name":"Tokyo Woman's Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5491-3460","authenticated-orcid":false,"given":"David W","family":"Johnson","sequence":"additional","affiliation":[{"name":"Princess Alexandra Hospital"},{"name":"Australasian Kidney Trials Network, University of Queensland, Brisbane, Australia"},{"name":"Translational Research Institute, Brisbane, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis L","family":"Huang","sequence":"additional","affiliation":[{"name":"Eastern Health Integrated Renal Service, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,10,27]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0896860819895364"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/2054358116679131"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/sdi.12712"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.05380518"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/08968608231175826"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2016.08.019"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-016-0344-z"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-022-01433-7"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-46654-2"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-018-00577-9"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/0896860819895362"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mpmed.2019.06.003"},{"key":"e_1_3_4_14_2","volume-title":"An introduction to peritoneal dialysis","author":"Australia KH","year":"2016","unstructured":"Australia KH. An introduction to peritoneal dialysis. Melbourne, VIC, Australia: Kidney Health Australia, 2016."},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/089686089901903S05"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2021.11.019"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-017-0403-0"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/08968608231195517"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.3747\/pdi.2014.00288"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.12321216"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1177\/08968608221080586"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/9780470316696"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-023-01703-y"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-023-01735-4"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.4103\/0971-4065.114496"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.3747\/pdi.2017.00283"}],"container-title":["Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08968608251385614","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08968608251385614","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08968608251385614","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:38:49Z","timestamp":1777675129000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08968608251385614"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,27]]},"references-count":26,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1177\/08968608251385614"],"URL":"https:\/\/doi.org\/10.1177\/08968608251385614","relation":{},"ISSN":["0896-8608","1718-4304"],"issn-type":[{"value":"0896-8608","type":"print"},{"value":"1718-4304","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,27]]}}}