{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:23:32Z","timestamp":1786116212286,"version":"build-2736575974"},"reference-count":17,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Vantive"},{"id":[{"id":"https:\/\/ror.org\/01vc30847","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Commencing peritoneal dialysis (PD) with a lower dose (incremental PD) is a common strategy to improve patient acceptance and reduce treatment burden. However, specific dietary protein recommendations for incremental PD are lacking. Methods: An interim analysis of the I-COPE PD study cohort aimed to assess one-year changes in serum albumin, body mass index (BMI), and metabolic parameters in a cohort of patients on incremental PD. Following local protocols, patients were categorized into two groups according to protein diet prescription: protein diet (PrD) \u2264 0.6 and PrD &gt; 0.6 g\/kg\/day. Longitudinal changes at baseline, 6 and 12 months were analyzed using mixed-effects models adjusted for age, sex, diabetes, residual kidney function and serum albumin at baseline. Results: We included 205 patients (mean age 63.3 \u00b1 14.2 years; 66% male; 30% diabetes; 92.2% CAPD) and in 45.4% a PrD \u2264 0.6 g\/kg\/day was prescribed. Baseline demographic, clinical, lab and therapeutic characteristics were well-balanced between the two diet groups. After one year of follow-up, the prevalence of patients persisting in incremental PD was not different between the two dietary groups (59.1% in PrD \u2264 0.6 vs. 63.3% in PrD &gt; 0.6, log-rank test = 0.759), and both groups showed a similar trend in serum albumin, characterized by an initial decline followed by stabilization (p = 0.647), with no significant differences in BMI (p = 0.461). Despite comparable dialysis adequacy, patients on PrD \u2264 0.6 exhibited significantly lower serum urea, phosphate, and potassium levels over time compared to the PrD &gt; 0.6 group. Conclusions: In patients starting incremental PD, the prescription of a lower protein diet could be associated with better control of uremic toxins, while serum albumin levels over time remain comparable to those observed in patients under a higher-protein diet.<\/jats:p>","DOI":"10.3390\/nu18152565","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T08:08:02Z","timestamp":1786003682000},"page":"2565","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["One-Year Nutritional and Metabolic Changes in Patients on Incremental Peritoneal Dialysis Under Different Protein Diets: A Multicenter Pragmatic Cohort Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4414-4597","authenticated-orcid":false,"given":"Silvio","family":"Borrelli","sequence":"first","affiliation":[{"name":"Unit of Nephrology, Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, 81031 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9362-0281","authenticated-orcid":false,"given":"Carlo","family":"Garofalo","sequence":"additional","affiliation":[{"name":"Unit of Nephrology, Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, 81031 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tino Paolo","family":"Ambrosino","sequence":"additional","affiliation":[{"name":"Unit of Nephrology, Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, 81031 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9374-0152","authenticated-orcid":false,"given":"Vincenzo","family":"Bellizzi","sequence":"additional","affiliation":[{"name":"\u201cSant\u2019Anna e San Sebastiano\u201d Hospital, 81100 Caserta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Andriella","sequence":"additional","affiliation":[{"name":"Unit of Nephrology, Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, 81031 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9121-3453","authenticated-orcid":false,"given":"Federica","family":"Marzano","sequence":"additional","affiliation":[{"name":"Unit of Nephrology, Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, 81031 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"German\u00f2","sequence":"additional","affiliation":[{"name":"Unit of Nephrology, Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, 81031 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Ruotolo","sequence":"additional","affiliation":[{"name":"Unit of Nephrology, Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, 81031 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianfranca","family":"Cabiddu","sequence":"additional","affiliation":[{"name":"Unit of Nephrology and Dialysis, University of Cagliari, 09121 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6118-4075","authenticated-orcid":false,"given":"Roberto","family":"Russo","sequence":"additional","affiliation":[{"name":"Unit of Nephrology and Dialysis, University of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerio","family":"Vizzardi","sequence":"additional","affiliation":[{"name":"Unit of Nephrology and Dialysis, Azienda Socio-Sanitaria Territoriale -Spedali Civili di Brescia, 25123 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2240-0801","authenticated-orcid":false,"given":"Diana","family":"Bertoni","sequence":"additional","affiliation":[{"name":"Unit of Nephrology and Dialysis, Azienda Socio-Sanitaria Territoriale -Spedali Civili di Brescia, 25123 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8995-936X","authenticated-orcid":false,"given":"Adamasco","family":"Cupisti","sequence":"additional","affiliation":[{"name":"Unit of Nephrology and Dialysis, University of Pisa, 56127 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5100-1009","authenticated-orcid":false,"given":"Loris","family":"Neri","sequence":"additional","affiliation":[{"name":"Unit of Nephrology and Dialysis, Azienda Sanitaria Locale CN2, 12051 Alba, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0591-8622","authenticated-orcid":false,"given":"Gaetano","family":"Alfano","sequence":"additional","affiliation":[{"name":"Unit of Nephrology and Dialysis, Azienda Ospedaliera di Modena, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gennaro","family":"Argentino","sequence":"additional","affiliation":[{"name":"Unit of Nephrology and Dialysis, Ospedale del Mare, 80147 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"D\u2019Alonzo","sequence":"additional","affiliation":[{"name":"Unit of Nephrology and Dialysis, Policlinico Gemelli, 00168 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0139-2264","authenticated-orcid":false,"given":"Paolo","family":"Chiodini","sequence":"additional","affiliation":[{"name":"Medical Statistics Unit, University of Campania \u201cLuigi Vanvitelli\u201d, 81031 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Paribello","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University Federico II, 80126 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Trepiccione","sequence":"additional","affiliation":[{"name":"Unit of Nephrology and Dialysis, Department of Medical Translational Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, 81031 Naples, Italy"},{"name":"Biogem, Institute of Molecular Biology and Genetics, 83031 Ariano Irpino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5686-2089","authenticated-orcid":false,"given":"Roberto","family":"Minutolo","sequence":"additional","affiliation":[{"name":"Unit of Nephrology, Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, 81031 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8532-0182","authenticated-orcid":false,"given":"Luca","family":"De Nicola","sequence":"additional","affiliation":[{"name":"Unit of Nephrology, Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, 81031 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"I-COPE Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1177\/0896860819895364","article-title":"International Society for Peritoneal Dialysis practice recommendations: Prescribing high-quality goal-directed peritoneal dialysis","volume":"40","author":"Brown","year":"2020","journal-title":"Perit. 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Nephrol."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/15\/2565\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T08:19:11Z","timestamp":1786004351000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/15\/2565"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,6]]},"references-count":17,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["nu18152565"],"URL":"https:\/\/doi.org\/10.3390\/nu18152565","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,6]]}}}