Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
Division of Nephrology and Blood Purification, Department of Internal Medicine, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
Ther Apher Dial. 2022 Dec;26(6):1226-1234. doi: 10.1111/1744-9987.13796. Epub 2022 Jan 18.
Although combined therapy with peritoneal dialysis (PD) and hemodialysis (HD) is widespread in Japan, its clinical utility has been reported only in retrospective or before-and-after test lacking a control group.
We conducted a prospective, multicenter, observational cohort study of 176 incident PD patients and compared patient survival and changes in clinical parameters between patients on different dialysis modalities.
During a median follow-up of 41 months, 47 patients transferred to combined therapy and 35 patients transferred directly to HD. Patients transferred to combined therapy had a significantly better survival than those transferred directly to HD. However, we could not establish this difference in a multivariate analysis because only six patients died among these groups. The decreases in urea nitrogen and serum creatinine were more prominent among patients directly transferred to HD.
This is the first report revealing clinical feasibility of transfer to combined therapy for PD patients.
尽管腹膜透析（PD）和血液透析（HD）联合治疗在日本已广泛应用，但相关临床效果仅在回顾性或缺乏对照组的前后测试中得到报告。
我们进行了一项前瞻性、多中心、观察性队列研究，纳入了 176 例新发生的 PD 患者，并比较了不同透析方式患者的生存情况和临床参数变化。
在中位随访 41 个月期间，47 例患者转为联合治疗，35 例患者直接转为 HD。与直接转至 HD 的患者相比，转为联合治疗的患者生存情况显著更好。然而，由于仅在这两个组中有 6 例患者死亡，因此我们无法在多变量分析中确定这种差异。直接转至 HD 的患者的尿素氮和血清肌酐降低更为显著。
这是第一项揭示 PD 患者转至联合治疗的临床可行性的报告。
