Incremental haemodialysis

The majority of incidental haemodialysis patients are systematically treated at the rate of three sessions per week, regardless of their level of residual kidney function. Incremental haemodialysis is a therapeutic strategy adapted to the residual kidney function level of each patient, to offer patients only the "dialysis dose" needed to supplement their residual kidney function, while ensuring that they achieve the objective of total clearance (renal + per-HD) recommended (weekly Standard Kt/V urea > 2.3 volumes. Incremental haemodialysis therefore allows a lower dose and lower dialysis frequency in patients with residual kidney function. Incremental haemodialysis through better residual kidney function preservation could improve patient survival and also have other benefits in terms of quality of life, preservation of vascular access and in terms of decreased expenditure health. Some logistical hurdles make its safely prescription still difficult but software should soon be made available to practitioners for a simpler and more accurate daily management of this prescription. (C) 2018 Published by Elsevier Masson SAS on behalf of Societe francophone de nephrologie, dialyse et transplantation.