Complementary use of peritoneal and hemodialysis: Therapeutic synergies in the treatment of end-stage renal failure patients

Kawanishi, Hideki; McIntyre, Chris

doi:10.1038/sj.ki.5002603

Cited by 10 publications

(6 citation statements)

References 25 publications

(14 reference statements)

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“…Previously, we reported that the mean age of patients who selected "PD first" were younger compared with that of patients on HD [16]. In the present study, there were no differences in mean age of patients who needed HD as complementary dialysis modality and those patients who started PD as "PD first", indicating that a larger portion of PD patients needed HD as complementary dialysis modality as stated elsewhere [12]. Besides, in spite of treatment with PD and HD in combination, approximately 45% of patients left from PD therapy.…”

Section: Discussionsupporting

confidence: 72%

“…Combination therapy with HD and PD allows for the partial separation of the two essential components of effective RRT, i.e., fluid removal and solute clearance [8][9][10][11][12][13]. In spite of using PD and HD in combination, peritoneal membranes gradually lose the ability to maintain adequate dialysis and many patients switch to HD only [14].…”

Section: Introductionmentioning

confidence: 99%

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Starting with PD Enables Diversity of Later Treatments

Suzuki

Hoshi²,

Inoue³

et al. 2014

J Nephrol Ther

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Background: Various reasons for "Peritoneal Dialysis (PD) First" rather than hemodialysis (HD) have been presented, such as better preservation of residual renal function (RRF), longer survival, and lower incidence of hospitalization. In spite of these advantages for "PD First", in Japan as well as in the United States the annual rate of patients receiving PD has been reduced to less than 10%. One of the major reasons against selecting PD is that a large proportion of PD patients are transferred from PD to HD in less than 5 years. Our "PD First" policy is based on the diversity of modalities available after discontinuing PD therapy. The purpose of this study was to examine the follow-up of patients who selected "PD First" as the initial treatment of end-stage renal disease (EDRD) between April 1997 and December 2010.Methods: Sex, age, primary underlying diseases and selection of modalities were collected retrospectively. Results:A total of 377 (59.2 ± 8.3 years old; female/male: 255/122) patients were introduced to PD therapy as "PD First." Patients who were very old, with cardiovascular problems, senile dementia, and neoplasms that were forced to select PD were excluded. One hundred and sixty patients started HD as complementary dialysis therapy and then continued with PD + HD in combination until transfer to HD, transplantation or home HD. Among them, 10 patients received transplants and 22 patients were transferred to home HD. One hundred and twenty eight patients were switched from PD to HD for various reasons. Overall patients' survival after 5 and 10 years was 84.8% and 55.8%, respectively. Conclusion:Our data shows a diversity of modalities for selection after discontinuing PD therapy alone, as well as providing a rationale to support PD as the initial renal replacement modality for end-stage renal disease patients.

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Section: Discussionsupporting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Starting with PD Enables Diversity of Later Treatments

Suzuki

Hoshi²,

Inoue³

et al. 2014

J Nephrol Ther

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“…Additional use of PD also has inherent risks of the complications of both therapies, both in terms of access and cumulative metabolic stress. However, PD and HD have been used in a combined approach 30 in patients failing on either initial solo modality or even de novo at the start of renal replacement therapy. 31 Peritoneal dialysis versus hemodialysis.…”

Section: Specific Dialysis-related Risksmentioning

confidence: 99%

Starting dialysis is dangerous: how do we balance the risk?

McIntyre

Rosansky

2012

Kidney International

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Recent studies of timing of dialysis initiation have challenged the recent trend to earlier initiation of therapy. The observed outcomes though are a consequence of the balance between the risks of advanced uremia versus the inherent dangers relating to dialysis therapy itself. Many of these risks are inherent in how dialysis treatment is currently carried out, and may indeed be amenable to mitigation, through refinement of clinical practice (and potentially modality choice). This article aims to lay out a discussion relating to patient outcomes being the composite result of this balance, pivoting on the vulnerability of a particular patient to these attendant risks.

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“…There are several types of PDþHD employed worldwide. 35 In Japan, PDþHD is mainly used for long-term PD patients to continue PD after loss of RRF. 25,26 Indeed, most PDþHD patients in this study had transferred from PD due to fluid overload and/or underdialysis after RRF decline.…”

Section: Discussionmentioning

confidence: 99%

Health-related quality of life on combination therapy with peritoneal dialysis and hemodialysis in comparison with hemodialysis and peritoneal dialysis: A cross-sectional study

et al. 2020

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Background: The health-related quality of life (HRQOL) of dialysis patients has not been well examined, especially in combination therapy with peritoneal dialysis and hemodialysis (PD+HD) patients. We compared the HRQOL of PD+HD patients with that of HD and PD patients. Methods: A multicenter, cross-sectional study was conducted on 36 PD+HD, 103 HD, and 90 PD patients in Japan who completed the Kidney Disease Quality of Life Short Form 36, version 1.3. HRQOL scores were summarized into physical- (PCS), mental- (MCS), role/social- (RCS), and kidney disease component summaries (KDCS). Results: Of the PD+HD patients, 31 (86%) transferred from PD and 5 (14%) transferred from HD. They had the longest dialysis vintage and the smallest urine volume. PCS, MCS, and KDCS HRQOL scores of PD+HD patients were comparable with those of HD and PD patients. However, the RCS score for PD+HD was significantly higher than that for HD ( p = 0.020) and comparable with that for PD. PD+HD and PD were associated with significantly higher RCS scores than HD after adjusting for age, gender, diabetic nephropathy, dialysis vintage, ischemic heart disease, and peripheral arterial disease. Conclusions: For RCS, HRQOL in PD+HD patients was better than that in HD and comparable with that in PD patients, whereas the PCS, MCS, and KDCS HRQOL scores of PD+HD patients were comparable with those of HD and PD patients.

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Complementary use of peritoneal and hemodialysis: Therapeutic synergies in the treatment of end-stage renal failure patients

Cited by 10 publications

References 25 publications

Starting with PD Enables Diversity of Later Treatments

Starting with PD Enables Diversity of Later Treatments

Starting dialysis is dangerous: how do we balance the risk?

Health-related quality of life on combination therapy with peritoneal dialysis and hemodialysis in comparison with hemodialysis and peritoneal dialysis: A cross-sectional study

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