Effect of proactive combination therapy with peritoneal dialysis and hemodialysis on technique survival and mortality.

IF 1.1 4区 医学 Q4 ENGINEERING, BIOMEDICAL
Kei Nagai, Atsushi Ueda
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Abstract

Purpose: Clinically relevant evidence for the timing of starting combination therapy with peritoneal dialysis and hemodialysis remains scarce. We retrospectively examined whether combination therapy during the induction phase of dialysis prolongs peritoneal dialysis duration.

Methods: This retrospective study includes 160 patients who underwent combination therapy from 20 dialysis facilities. Four groups were categorized: combination at peritoneal dialysis induction (n = 12, Proactive combination group), and combination following peritoneal dialysis durations of < 2 years (n = 65), 2-5 years (n = 70), or > 5 years (n = 13). Differences in technique survival of dialysis, mortality, and hospitalization due to cardiovascular events in the groups were observed.

Results: The Proactive combination group had the longer mean duration of combination therapy (3.18 years) comparing to that of combination therapy following peritoneal dialysis (1.45 years), but total peritoneal dialysis duration was shorter than in control groups (4.02 years). Of the 160 cases in the entire cohort, there were 8 deaths, 18 ischemic heart disease hospitalizations, and 18 stroke hospitalizations. The Proactive group had lower crude mortality rate (0/12 cases, 0.0%) and crude hospitalization rate for ischemic heart disease (1/11, 8.3%) than the other groups. However, this cohort study did not have enough statistical power to adjust for patients' background, and we were unable to fully examine the differences in such clinical outcomes by the timing of initiation of combination therapy.

Conclusion: Use of combination therapy in the induction phase might prolong the duration of combination therapy, but is not necessarily effective for prolonging peritoneal dialysis technique survival.

Abstract Image

腹膜透析和血液透析主动联合疗法对技术存活率和死亡率的影响。
目的:关于开始腹膜透析和血液透析联合治疗时机的临床相关证据仍然很少。我们回顾性研究了透析诱导阶段的联合疗法是否会延长腹膜透析时间:这项回顾性研究包括来自 20 家透析机构的 160 名接受联合疗法的患者。分为四组:腹膜透析诱导期联合治疗组(12 人,主动联合治疗组)和腹膜透析持续 5 年后联合治疗组(13 人)。观察各组透析技术存活率、死亡率和心血管事件住院率的差异:结果:与腹膜透析后联合治疗的平均持续时间(1.45 年)相比,主动联合治疗组的平均持续时间更长(3.18 年),但腹膜透析的总持续时间比对照组短(4.02 年)。在整个队列的 160 个病例中,有 8 人死亡,18 人因缺血性心脏病住院,18 人因中风住院。积极组的粗死亡率(0/12 例,0.0%)和粗缺血性心脏病住院率(1/11 例,8.3%)低于其他组。然而,这项队列研究没有足够的统计能力对患者的背景进行调整,我们也无法全面研究联合疗法的启动时间在这些临床结果上的差异:结论:在诱导阶段使用联合疗法可能会延长联合疗法的持续时间,但并不一定能有效延长腹膜透析技术的存活率。
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来源期刊
Journal of Artificial Organs
Journal of Artificial Organs 医学-工程:生物医学
CiteScore
2.80
自引率
15.40%
发文量
68
审稿时长
6-12 weeks
期刊介绍: The aim of the Journal of Artificial Organs is to introduce to colleagues worldwide a broad spectrum of important new achievements in the field of artificial organs, ranging from fundamental research to clinical applications. The scope of the Journal of Artificial Organs encompasses but is not restricted to blood purification, cardiovascular intervention, biomaterials, and artificial metabolic organs. Additionally, the journal will cover technical and industrial innovations. Membership in the Japanese Society for Artificial Organs is not a prerequisite for submission.
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