Incremental dialysis: a procedure different from infrequent dialysis

Abstract

The aim of the review is to provide the ultimate distinction between incremental dialysis and what is referred to as infrequent dialysis. Infrequent dialysis is defined as any hemodialytic schedule that includes fewer than three hemodialysis sessions per week. Nonetheless, infrequent dialysis could be defined as a therapy that requires close clinical and nutritional monitoring, and it should also be accompanied by a slightly hypoproteic dietetic approach. Incremental dialysis (CDDP) is a well-defined therapeutic program requiring significant clinical monitoring; it begins in the outpatient clinic when patients shift to a hypoproteic diet (0.6 g/kg per day) with or without essential amino acids and a low-salt diet supplemented by one dialysis session per week. The incremental dialysis program is strictly tailored on the residual renal function (RRF) trend and it represents a time variable for a therapeutic “bridge” that must provide a favourable metabolic status together with good quality of life. Recent studies have demonstrated lower mortality rates compared with thrice-weekly dialysis and a neutral input/output balance of the phosphorus pool. Further studies are needed to confirm the safety and validity of this therapeutic choice.