STarting incrEmental Prescription of Peritoneal Dialysis

Description

Kidney failure is fatal without dialysis. Peritoneal dialysis (PD) completed at home offers greater flexibility and autonomy for patients . However, PD is often prescribed for 24 hours/day, 7 days/week for every patient starting dialysis. This practice is not evidence-informed, may be unnecessary and potentially harmful. The STEP-PD trial aims to determine the optimal approach to commencing patients on PD through starting at low dose PD and incrementing over time.

Interventions

• Incremental PD (Other)
  Incremental PD: Commence PD using goal-directed PD prescription ≤14 exchanges/week for continuous ambulatory PD (CAPD) or ≤21 exchanges/week for automated PD (APD) with no day dwell until an indication for increase in the PD dose (trigger point) is reached.
• Full dose PD (Other)
  Full dose PD: Commence with 24 hours, 7 days/week PD (i.e., CAPD ≥28 exchanges/week or APD (overnight) with day dwell (i.e., no dry abdomen)).

Eligibility criteria

Conditions

Locations

• Blacktown — Blacktown, New South Wales, Australia
• John hunter Hospital — Newcastle, New South Wales, Australia
• Wollongong Hospital — Wollongong, New South Wales, Australia
• Princess Alexandra Hospital — Brisbane, Queensland, Australia
• Eastern Health — Box Hill, Victoria, Australia
• Waitemata — Auckland, New Zealand
• Hallym University Sacred Heart Hospital — Chuncheon, Gangwon-do, South Korea
• Kyungpook National University Chilgok Hospital — Daegu, South Korea
• Kyungpook National University — Daegu, South Korea
• Taichung Veterans General Hospital — Taichung, Xitun District, Taiwan
• Banphaeo General Hospital — Ban Phaeo, Changwat Samut Sakhon, Thailand
• Nakhon Pathom Hospital — Nakhon Pathom, Mueang Nakhon Pathom District, Thailand
• Samut Prakan Hospital — Mueang Samut Prakan, Mueang Samut Prakan District, Thailand
• King Chulalongkorn Memorial Hospital — Bangkok, Pathum Wan, Thailand