Lower protein diet may be better in incremental peritoneal dialysis

A new study published in the journal Nutrients suggests that patients starting peritoneal dialysis (PD) with a lower protein diet may experience better control of uremic toxins over time. Researchers from the University of Campania Luigi Vanvitelli in Naples, Italy, analyzed data from the I-COPE PD study cohort, which included 205 patients on incremental PD.

These patients were divided into two groups based on their protein diet prescription: a lower protein diet (PrD) of ≤0.6 g/kg/day for 45.4% of the patients and a higher protein diet (PrD ≥0.6 g/kg/day).

At baseline and after six and 12 months, the researchers observed that the prevalence of patients continuing with incremental PD did not differ between the two groups. Both groups showed a similar trend in serum albumin, with an initial decline followed by stabilization. However, patients on the PrD ≤0.6 group had significantly lower serum levels of urea, phosphate, and potassium compared to those on the PrD ≥0.6 group, despite having comparable dialysis adequacy.

The authors conclude that their observational analysis provides the first evidence suggesting potential benefits and safety in reducing protein intake for patients initiating PD with an incremental approach. Two authors disclosed financial ties to biopharmaceutical companies, with one receiving funding from Vantive, which partially funded the study.