Abstract
Most combined peritoneal dialysis and hemodialysis therapies are used to compensate for the lack of dialysis volume and efficiency in pre-started peritoneal dialysis patients. The aim was to determine the effects on both peritoneal dialysis and residual renal function when proactively combined therapy is started at dialysis induction. This report was based on observation of 10 patients who initiated dialysis therapy with a combination of peritoneal and hemodialysis at induction, and the control group consisted of 24 patients with peritoneal monotherapy in a single dialysis center. The technical survival of peritoneal dialysis therapy and urinary volume and creatinine clearance as residual renal function were assessed. Technical survival of peritoneal dialysis during the 5-year observation period was much better in patients who started with proactive combination therapy than with peritoneal dialysis monotherapy. Between induction and 24 months later, median urinary volume (interquartile value) changed from 1500 (1100–1583) to 800 (545–1875) mL/day and from 1600 (1300–2150) to 1480 (115–1885) mL/day for peritoneal alone and for combination therapy, respectively. Creatinine clearance values changed from 7.0 (6.0–8.7) to 2.0 (1.0–3.0) mL/min for peritoneal alone and from 6.0 (4.0–7.3) to 3.0 (0.5–4.0) mL/min for combination therapy. Though some possible confounding factors, including selection bias, cannot be ruled out, this investigation suggests the benefit of proactive combination dialysis therapy on the sustainability of peritoneal dialysis and residual renal function.
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Data availability
The dataset that supports the findings of this study is available on request from the corresponding author (AU).
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Conception, design, and supervision of the study: AU. Data analysis: KN. Data collection: AU. Writing of the first draft of the manuscript: KN. All the authors agree with the manuscript results, conclusions, and publication.
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All the authors have declared no competing interests.
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Ethics approval was obtained from Hitachi General Hospital.
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The protocol of the observational study waived the need for individual consent because only the output form without any individual data was disclosed to the analyst. The names, address, and any other personalized data of the participants were completely deleted from the linked dataset to protect their privacy.
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Nagai, K., Ueda, A. Sustainability of peritoneal dialysis and renal function with proactive combination therapy. J Artif Organs 26, 335–339 (2023). https://doi.org/10.1007/s10047-022-01375-8
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DOI: https://doi.org/10.1007/s10047-022-01375-8