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Kidney Week

Abstract: TH-PO837

The Superiority of Combination Therapy with Peritoneal Dialysis and Hemodialysis over Conventional Hemodialysis

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

  • Nakamura, Hironori, Shinonoi General Hospital, Nagano, Japan
  • Mariko, Anayama, Shinonoi General Hospital, Nagano, Japan
  • Makino, Yasushi, Shinonoi General Hospital, Nagano, Japan
  • Nagasawa, Masaki, Shinonoi General Hospital, Nagano, Japan
Background

Combination therapy consisting of peritoneal dialysis (PD) and hemodialysis (HD) is a type of renal replacement therapy that possesses the advantages of both types of dialysis. In Japan, approximately 20% of all PD patients receive this unique combination of PD and HD (PD+HD) therapy, which consists of 6 days of PD and 1 session of HD a week. However, little is known about the differences in clinical characteristics or QOL between PD+HD and HD patients.

Methods

The aim of this study was to verify the superiority of PD+HD over HD in the clinical characteristics and Kidney Disease Quality of Life Short Form (KDQOL-SF36) score in dialysis patients. One single-center cross-sectional comparative study was conducted. Seven PD+HD patients and 11 control patients were included; age- (±3 years) and dialysis duration- (±5 months) matched controls were selected from HD patients who were undergoing HD thrice a week in our dialysis center.

Results

The mean age of the patients was 73.1 ± 5.7 years, and dialysis duration was 66.7 ± 42.3 months. Laboratory data showed that the values for blood urea nitrogen (44.0 ± 9.2 vs. 58.6 ± 13.4 mg/dL, p = 0.015), potassium (4.1 ± 0.70 vs. 5.0 ± 0.88 mEq/L, p = 0.028), iron (72.5 ± 17.0 vs. 42.3 ± 15.5 mg/dL, p = 0.005), transferrin saturation (27.0% ± 7.8% vs. 17.9% ± 6.4%, p = 0.039), pH (7.40 ± 0.02 vs. 7.34 ± 0.04, p = 0.005), and HCO3 (23.6 ± 2.8 vs. 19.7 ± 1.7 mEq/L, p = 0.018) were significantly better in PD+HD than HD patients. Total protein (5.5 ± 0.48 vs. 6.2 ± 0.39 mg/dL, p = 0.01) and albumin (2.7 ± 0.48 vs. 3.3 ± 0.38, p = 0.019) levels were lower in PD+HD than HD patients. Regarding the KDQOL questionnaire results, the score for the item indicating patient satisfaction to dialysis care was significantly higher in PD+HD than HD (90.4 ± 8.9 vs. 66.6 ± 19.2 points, p = 0.004). No significant items were observed for the superiority of HD over PD+HD.

Conclusion

Our results suggested that PD+HD may have meaningful advantages in terms of iron metabolism, acid–base balance, and patient satisfaction compared with those in conventional HD in this study population.