[en] Both residual kidney function (RKF) at the start of Peritoneal Dialysis (PD) and its preservation during follow-up may influence the outcome of patients undergoing this therapy. Maintaining a significant RKF delays the development of complications of chronic kidney disease, and prevents the appearance of features which contribute to the well-known cardiovascular risk of these patients. The information concerning the compared risk of decline of RKF in patients starting PD under manual (CAPD) or automated (APD) regimes is limited and controversial. The present study pursued the main objective of comparing the rate of decline of RKF in patients incident on either CAPD or APD therapy. Secondarily, the prognostic significance of both baseline and time-related RKF on main PD-related outcome variables was investigated. The research followed an observational, multicenter design. We applied multivariate strategies of analysis, including time-dependent approaches, intending to correct for potential assignment and indication biases. The results indicate that APD may associate a faster decline of RKF than CAPD, as shown by an increased risk of anuria during follow-up. This risk appears to be restricted to patients starting PD with lower levels of RKF. The results of the analysis confirm that both baseline RKF and its preservation during follow-up bear an independent influence on patient and technique survival, as also on the risk of peritoneal infection. The results of the present study should be taken into consideration by centers which follow a policy of permitting direct access to APD to patients incident on PD, based solely on individual preference.

[gl] A función renal residual (FRR) ó inicio da diálise peritoneal (DP) e a súa preservación no tempo unha vez iniciado o tratamento sustitutivo renal, poden influir sobre o pronóstico dos pacientes tratados con esta terapia, ya que retarda a aparición de complicacións da enfermidade renal crónica e atenúa o retrasa a aparición de rasgos da enfermidade, que contribúen ó risco cardiovascular xeral destes pacientes. A información disponible sobre o efecto comparado das dúas modalidades básicas de diálise peritoneal (DPCA e DP automática DPA) sobre a FRR e escasa e inconsistente. O presente estudio tivo como obxectivos principais comparar o ritmo de declive da FRR en pacientes incidentes en DP tratados cunha u outra modalidade. De manera secundaria, investigouse o significado pronóstico da FRR sobre variables pronósticas esenciais no ámbito da DP. A investigación seguiu un diseño observacional multicéntrico, incluindo análises dependentes de tempo, co fin de corrixir os posibles sesgos de asignación e indicación. Os resultados mostran que a DPA parece asociar un efecto mais negativo que a DPCA sobre a evolución da FRR, ó exponer ós pacientes a un maior risco de desenrrolar anuria. Os análises estratificados indican que este efecto restrínsexe ós pacientes que inician DP con niveles mais baixos de FRR. Os resultados do análise confirman que tanto a FRR basal como a súa preservación no tempo inflúen de manera independiente sobre a supervivencia do paciente e da ténica de DP, así coma sobre o risco de infección peritoneal. Os resultados deste estudio deben ser tidos en consideración por centros nos que a política asistencial inclúa permitir o acceso directo de pacientes en DP a procedimentos automatizados, basándose exclusivamente en cuestións de preferencia individual.