A Case in Which Renal Function and Peritoneal Function Were Maintained for Ten Years by Proactive Combination Therapy with Peritoneal Dialysis and Hemodialysis.

To avoid loss of residual renal function (RRF) and to enhance solute clearance, we sometimes, from the initiation of peritoneal dialysis (PD) therapy, combine PD with hemodialysis (HD) that removes little or no fluid. In one typical valuable case, a 51-year-old woman with diabetic nephropathy who selected combined PD and HD therapy as her first dialysis method has continued on that therapy for 10 years. Her dialysis schedule consists of 5 PD days and 1 HD day without fluid removal weekly. Because this combination therapy was proactively started at dialysis initiation, good fluid control could be kept with urinary excretion and PD ultrafiltration. Stable peritoneal equilibration test data indicate that peritoneal resting might be expected to be beneficial for the preservation of peritoneal function. This case demonstrates that proactive combination therapy can be extremely useful for preserving both RRF and peritoneal function, indicating a good prognosis.