Abstract: FR-PO441
Comparison of Clinical Outcomes between High-Start and Low-Start Dialysate Fill Volume among Patients with CKD on Peritoneal Dialysis at the National Kidney and Transplant Institute: A Randomized Controlled Trial
Session Information
- Home Dialysis - 1
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Author
- Rapacon, Rhaffy Bearneza, National Kidney and Transplant Institute, Quezon City, National Capital Region, Philippines
Background
There is a lack of consensus among nephrologists on the optimal peritoneal dialysis(PD) choice of starting on low fill or high fill volume due to data gaps.
Methods
This randomized controlled trial included 50 CKD patients at National Kidney Transplant Institute from December 2023 to March 2024. Patients were randomly allocated into two groups to receive either high-start or low-start dialysate fill volume. Endpoints of the study are adverse events and changes from baseline of PD parameters at day 14 of the treatment period.
Results
A significant difference in the pre-and post-treatment in terms of improved eGFR in the low-start group (4.3±2.5 vs 6.9±4.0; D =2.63; p<0.001); increased serum albumin in the high-start group (3.2±0.5 vs 3.5±0.4; D =0.30, p=0.025); and decreased BUN in both high-start (106.2±42.8 vs 53.1±21.3; D =53.09; p<0.001) and low-start group (106.1±36.7 vs 50.8±19.6; D =53.09; p<0.001). In terms of adverse events, bleeding was significantly associated with low-start fill volume (p=0.037). However, groups did not vary significantly in terms of pericatheter leak (RR=1.67; p=0.440); abdominal pain (RR=1.27, p=0.659); swelling (RR=1, p=1); catheter migration (p=0.018); obstruction (RR=0.75, p=0.683); peritonitis (p=0.312) and other complications (RR=1.5, p=0.637).
Conclusion
High-start fill volume resulted in significantly improved post-treatment serum albumin and BUN levels. It was well tolerated and associated with significantly lower bleeding rates compared to low-start fill volume.