Kidney Week

Abstract: TH-PO374

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

Session Information

• Dialysis: Peritoneal Dialysis - I
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 703 Dialysis: Peritoneal Dialysis

Authors

• Maruyama, Yukio, The Jikei University School of Medicine, Tokyo, Japan

Yukio Maruyama,

• Yokoyama, Keitaro, The Jikei University School of Medicine, Tokyo, Japan

Keitaro Yokoyama,

• Tanaka, Yoshihide, Toho University School of Medicine, Tokyo, Japan

Yoshihide Tanaka,

• Sakai, Ken, Toho University School of Medicine, Tokyo, Japan

Ken Sakai,

• Kanno, Yoshihiko, Tokyo Medical University, Tokyo, Japan

Yoshihiko Kanno,

• Sanaka, Tsutomu, Edogwa Hospital, Medical Center, Tokyo, Japan

Tsutomu Sanaka,

• Sakurada, Tsutomu, St. Marianna University School of Medicine, Kawasaki, Japan

Tsutomu Sakurada,

• Ryuzaki, Munekazu, Tokyo Saiseikai Central Hospital, Tokyo, Japan

Munekazu Ryuzaki,

• Nakayama, Masaaki, St Luke''s International Hospital, Tokyo, Japan

Masaaki Nakayama,

• Higuchi, Chieko, Division of Internal Medicine, Tokyo Women's Medical University Medical Center East, Tokyo, Japan

Chieko Higuchi,

• Maeba, Teruhiko, Asao Kidney Clinic, Kawasaki, Japan

Teruhiko Maeba,

• Hosoya, Tatsuo, The Jikei University School of Medicine, Tokyo, Japan

Tatsuo Hosoya,

Group or Team Name

• EARTH (Evaluation on the Adequacy of Renal Replacement Therapy) 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. We conducted a prospective study to investigate its clinical efficacy in Japan.

Methods

In this prospective multicenter study, we recruited 42 patients started PD from January 1, 2011 to December 31, 2016 (61±9 years, 35 males, and 14 diabetes), and collected clinical information at the start of combined therapy and six months after initiation, prospectively. The changes in parameters between the start of combined therapy and six months later were evaluated using a paired t-test or the Wilcoxon signed-rank test.

Results

Two cases transferred to HD within six months. In the remaining cases, body weight, urine volume, and serum creatinine levels decreased, whereas hemoglobin and serum albumin levels increased. Additionally, dialysate-to-plasma ratio of creatinine (D/P Cr), obtained from a peritoneal equilibration test (PET) decreased significantly from 0.71 ± 0.10 to 0.66 ± 0.10 (P = 0.01) (Figure 1).

Conclusion

In this prospective observational study, both underdialysis and overhydration appear to have been improved by switching from PD alone to combined therapy. Additionally combined therapy could limit further deterioration of the peritoneal membrane. Long-term patient and technical survival will be clarified by the results of ongoing our larger prospective study.