A randomised prospective open label comparative study: To evaluate the effect of an interventional approach (aimed at maintaining near pre dialytic ECW) vs a conventional approach (towards volume control) in incident peritonial dialysis patients on rate of decline of RRF and its association with the cardiovascular outcomes

It is a randomized prospective open label comparative study.  The proposed study is based on the fact that pre dialysis patients in stage 4 usually do not require dialysis unless necessitated by any indication for emergency dialysis. In the absence of any fixed and absolute method to calculate dry weight in PD patients, we hypothesize that if the hycirations status of incident dialysis patients on PD is maintained at or near pre dialysis stage; there would be good control of fluid status without compromising on RRF. To this effect, we propose to conduct a pilot study to test this hypothesis.The screening and enrollment shall be done over a period of two years.  All patients conforming to the inclusion and exclusion criteria and give consent shall be enrolled. Enrolled patients shall undergo 1:1 randomization at the time of initiation of peritoneal dialysis where every alternate patient would enter the interventional group.  Both groups of patients will be thoroughly educated at the time of enrollment to recognize signs of fluid overload and dehydration and will be informed to come for hospital visit in case of such an event happening.The patients will also be given patient diaries to maintain a record at home and the data collected will relate to signs and symptoms of fluid imbalance including the body weight and BP.MFBIA would be used to measure ECW. RRF shall be measured at baseline and at every two months interval as a 24 hrs mean of renal clearance of urine & Creatinine.  Blood pressure will be taken during the bimonthly visits of subjects to the centre. Bloodwork at baseline and at follow-up. Lipid profile will be done at baseline and 6months.Evaluation of PET as per the ISPD guidelines 2005 will be done. Quantitative variables and qualitative variables will be compared by students t test and chi square tests. A p value < 0.05 is taken as significant.