Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep 29;38(10):2143-2151.
doi: 10.1093/ndt/gfad019.

Comparable outcomes between a combination of peritoneal dialysis with once-weekly haemodialysis and thrice-weekly haemodialysis: a prospective cohort study

Miho Murashima  1 , Takayuki Hamano  1   2 , Masanori Abe  3   4 , Ikuto Masakane  5
Affiliations

Comparable outcomes between a combination of peritoneal dialysis with once-weekly haemodialysis and thrice-weekly haemodialysis: a prospective cohort study

Miho Murashima et al. Nephrol Dial Transplant. .

Abstract

Background: Outcomes of a combination of peritoneal dialysis (PD) and once-weekly haemodialysis (PD + HD) have not been extensively studied.

Methods: This prospective cohort study using the Japanese Society for Dialysis Therapy Renal Data Registry included those who transitioned from PD to PD + HD therapy or thrice-weekly HD from 2011 to 2018. Exposure was PD + HD therapy compared with thrice-weekly HD. The outcome was time to all-cause or cause-specific death. Associations between PD + HD therapy and outcomes were examined by Cox regression. Sensitivity analyses were performed by propensity score (PS) matching, PS matching with a shared frailty model in which dialysis facilities were treated as a random effect, inverse probability weighting (IPW), PS adjustment, PS stratification, competing risk regression and on-treatment analyses in which data were censored at the transition to thrice-weekly HD for those on PD + HD therapy.

Results: During the study period, 1001 subjects transitioned to PD + HD therapy and 2031 to thrice-weekly HD. During a median follow-up of 3.5 years, 575 subjects died. All-cause, cardiovascular, congestive heart failure-related or infection-related mortality were not significantly different between those on PD + HD and those on thrice-weekly HD [hazard ratio 0.95 (95% confidence interval 0.78-1.16), 1.26 (0.92-1.72), 1.24 (0.77-1.99) and 0.89 (0.57-1.39), respectively]. Sensitivity analyses yielded similar results except that PD + HD therapy was associated with significantly lower all-cause mortality by PS adjustment and PS matching with the shared frailty model and lower infection-related mortality by PS adjustment and IPW.

Conclusions: PD + HD therapy was associated with similar or potentially lower mortality compared with thrice-weekly HD. Considering a flexible lifestyle, PD + HD therapy could be a great option.

Keywords: combination of peritoneal dialysis and haemodialysis; haemodialysis; mortality.

PubMed Disclaimer