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Abstract: TH-PO374

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

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis


  • Maruyama, Yukio, The Jikei University School of Medicine, Tokyo, Japan
  • Yokoyama, Keitaro, The Jikei University School of Medicine, Tokyo, Japan
  • Tanaka, Yoshihide, Toho University School of Medicine, Tokyo, Japan
  • Sakai, Ken, Toho University School of Medicine, Tokyo, Japan
  • Kanno, Yoshihiko, Tokyo Medical University, Tokyo, Japan
  • Sanaka, Tsutomu, Edogwa Hospital, Medical Center, Tokyo, Japan
  • Sakurada, Tsutomu, St. Marianna University School of Medicine, Kawasaki, Japan
  • Ryuzaki, Munekazu, Tokyo Saiseikai Central Hospital, Tokyo, Japan
  • Nakayama, Masaaki, St Luke''s International Hospital, Tokyo, Japan
  • Higuchi, Chieko, Division of Internal Medicine, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
  • Maeba, Teruhiko, Asao Kidney Clinic, Kawasaki, Japan
  • Hosoya, Tatsuo, The Jikei University School of Medicine, Tokyo, Japan

Group or Team Name

  • EARTH (Evaluation on the Adequacy of Renal Replacement Therapy) Study Group

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.


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.


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).


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.