| [ Summary ] |
The fundamental objectives of dialysis are to maintain solute clearance rates and ultrafiltration (UF). If peritoneal dialysis (PD) patients are not maintained at target rates of clearance, they need to increase dialysis dosage but there are limitations on increasing doses of PD only, especially for patients with ultrafiltration failure (UFF). Therefore, combination PD with hemodialysis (HD) (PD+HD) therapy is the simpliest way to resolve this issue. Generally, prescription for PD+HD should be for 5-6 days/week PD and 1 session/week HD. For calculation of PD+HD, we adopt equivalent renal clearance (EKR) and transform to weekly Kt/V and evaluate it as total clearance. The indications for PD+HD are the lack of solute clearance, UFF, bad self-management and other factors including the hernia and diaphragmatic intercourse, as well as severe heart failure, controled by with strict fluid control. PD+HD can resolve the disadvantages of PD and over come complications, leading to higher QOL. It is expected that this will become the standard dialysis modality. |