Abstract: TH-PO834

The Effect of Combined Therapy with Peritoneal Dialysis and Hemodialysis on Patient Survival: A Prospective Multicenter Study in Japan

Session Information

  • Peritoneal Dialysis - I
    November 02, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Dialysis

  • 608 Peritoneal Dialysis

Authors

  • Maruyama, Yukio, EARTH (Evaluation on the Adequacy of Renal Replacement Therapy) Study Group, Tokyo, Japan
  • Sakurada, Tsutomu, EARTH (Evaluation on the Adequacy of Renal Replacement Therapy) Study Group, Tokyo, Japan
  • Hosoya, Tatsuo, EARTH (Evaluation on the Adequacy of Renal Replacement Therapy) Study Group, Tokyo, Japan
  • Yokoyama, Keitaro, EARTH (Evaluation on the Adequacy of Renal Replacement Therapy) Study Group, Tokyo, Japan
  • Nakayama, Masaaki, EARTH (Evaluation on the Adequacy of Renal Replacement Therapy) Study Group, Tokyo, Japan
  • Higuchi, Chieko, EARTH (Evaluation on the Adequacy of Renal Replacement Therapy) Study Group, Tokyo, Japan
  • Sanaka, Tsutomu, EARTH (Evaluation on the Adequacy of Renal Replacement Therapy) Study Group, Tokyo, Japan
  • Tanaka, Yoshihide, EARTH (Evaluation on the Adequacy of Renal Replacement Therapy) Study Group, Tokyo, Japan
  • Sakai, Ken, EARTH (Evaluation on the Adequacy of Renal Replacement Therapy) Study Group, Tokyo, Japan
  • Kanno, Yoshihiko, EARTH (Evaluation on the Adequacy of Renal Replacement Therapy) Study Group, Tokyo, Japan
  • Ryuzaki, Munekazu, EARTH (Evaluation on the Adequacy of Renal Replacement Therapy) Study Group, Tokyo, Japan

Group or Team Name

  • EARTH Study Group
Background

Combined therapy with peritoneal dialysis (PD) and hemodialysis (HD) was widely performed to correct underdialysis and/or overhydration in Japan. However, its clinical result was only reported in retrospective observational studies, and the effect on patient survival is unknown. Hence, we conducted a prospective study to investigate its clinical efficacy in Japan.

Methods

In this prospective multicenter study, we recruited 164 patients started PD from January 1, 2011 to December 31, 2016 (59±16 years, 118 males, and 61 diabetes), and collected clinical information on an annual basis until March 31, 2017.

Results

Median follow-up period was 35 months (range, 0-71 months). During follow-up, 21 patients were switched to the combined therapy with PD and HD, and 15 were switched to HD alone 30±16 and 23±13 months after PD initiation, respectively. The reasons for switching therapy were underdialysis in 8 (22%), overhydration in 12 (33%), both in 1 (3%), and others or unknown in 15 patients (42%). Nineteen patients (11.6%) died of all causes, including 6 (3.7%) died of CVD. Sixteen patients on PD alone, 1 patient on HD alone, and 2 patients on combined therapy were dead. Mortality after switching therapy was no significantly difference between patients on HD alone and those on combined therapy (Log-rank p=0.25, Figure 1).

Conclusion

The effect of switching combined therapy with PD and HD from PD alone on patient survival could not be inferior to switching HD directly. Long-term observation is needed to prove survival advantage of combined therapy.

Funding

  • Commercial Support