Clinical feasibility of transfer to combined therapy with peritoneal dialysis and hemodialysis for patients on peritoneal dialysis: A prospective multicenter study in Japan

Ther Apher Dial. 2022 Dec;26(6):1226-1234. doi: 10.1111/1744-9987.13796. Epub 2022 Jan 18.

Abstract

Introduction: Although combined therapy with peritoneal dialysis (PD) and hemodialysis (HD) is widespread in Japan, its clinical utility has been reported only in retrospective or before-and-after test lacking a control group.

Methods: We conducted a prospective, multicenter, observational cohort study of 176 incident PD patients and compared patient survival and changes in clinical parameters between patients on different dialysis modalities.

Results: During a median follow-up of 41 months, 47 patients transferred to combined therapy and 35 patients transferred directly to HD. Patients transferred to combined therapy had a significantly better survival than those transferred directly to HD. However, we could not establish this difference in a multivariate analysis because only six patients died among these groups. The decreases in urea nitrogen and serum creatinine were more prominent among patients directly transferred to HD.

Conclusion: This is the first report revealing clinical feasibility of transfer to combined therapy for PD patients.

Keywords: dialysate-to-plasma ratio of creatinine (D/P Cr); fluid overload; inadequate dialysis; residual renal function (RRF); β2 microglobulin.

Publication types

  • Observational Study
  • Multicenter Study

MeSH terms

  • Feasibility Studies
  • Humans
  • Japan
  • Kidney Failure, Chronic* / therapy
  • Peritoneal Dialysis*
  • Prospective Studies
  • Renal Dialysis
  • Retrospective Studies

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