Abstract: Ｏｂｊｅｃｔｉｖｅ：To retrospectively observe the clinical efficacy of modified gradul peritoneal dialysis (PD) and fulldose peritoneal dialysis.
Ｍｅｔｈｏｄｏｌｏｇｙ：All the patients who received PD treatment for 1 year were enrolled and divided into 2 groups according to the PD modality. Patients in fulldose peritoneal dialysis group received an exchange volume of 8 000 ml／d (traditional group), whereas in modified gradul PD group, the initiate PD exchange volume was 6 000 ml／d, and then adjusted on the basis of PD adequacy indexes at 1, 3, 6 and 12 months. Specifically, exchange volume was increased when total Kt／V (TKt／V)<17 or serum creatinine elevation was greater than 100 μmol／L (increamental group), while decreased when TKt／V>19 (decreamental group). PD adequacy indexes, eGFR descent rate and biochemical markers such as hemoglobin and serum albumin were collected and compared respectively.
Ｒｅｓｕｌｔｓ：116 patients were enrolled, with 52 patients in traditional group, 33 patients in increamental group and 31 in decreamental group. At the end of 1 year, the exchange volumes were significantly increased in increamental group(P<0001), and decreased in decreamental group (P<0001). During the followup period, TKt／V in traditional group decreased significantly (P=0039), accompanied by significantly decrease in uKt／V(P<0001) and urine volume(P<0001), however with no change in ultrafiltration volume or pKT／V. In increamental group, uKt／V(P=0001) and urine volume(P<0001) decreased, pKt／V(P=0001) and ultrafiltration volume(P=0002) increased significantly. In decreamental group, pKT／V decreased significantly(P=0004), whereas uKt／V increased significantly (P=0039). The GFR descent rate in decreamental group was the lowest.
Ｃｏｎｃｌｕｓｉｏｎ：Modified gradul peritoneal dialysis was based on the dynamic changes of residual renal function and ensuring sufficient of dialysis adequacy, which was safe and effective, and proved to be better than traditional PD. For the patients whose residual renal function can be improved after PD, the decreamental PD is a better choice than traditional PD.