| Theme | Creation of hemodialysis modalities for new goals | |
|---|---|---|
| Title | Issues concerning combination therapy | |
| Publish Date | 2017/06 | |
| Author | Yu Honda | Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine |
| Author | Yukio Maruyama | Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine |
| [ Summary ] | Peritoneal dialysis (PD) is recommended as a first-line renal replacement therapy (RRT) for end-stage renal disease (ESRD). The reasons to support this notion are that residual renal function (RRF), a potent predictor of patient survival, is better preserved, there is an absence of disequilibrium symptoms, and higher quality of life (QOL) is provided for PD patients as compared to patients receiving hemodialysis (HD). However, PD alone is not always successful in correcting inadequate dialysis and overhydration after the loss of RRF. Additionally, it is widely recognized that peritoneal membranes gradually deteriorate with PD therapy. As a result, the efficiency of dialysis cannot be maintained. Combined therapy with PD and HD is a treatment option for PD patients who cannot control inadequate dialysis and/or overhydration after the loss of RRF. 20 % of all PD patients are estimated to be on this combination therapy in Japan. The clinical utility and issues related to this modality are examined. |
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