Comparison and causes of transfer from one dialysis modality

Comparison and causes of transfer from one dialysis modality to other

Submitted by Mr CS Soong

International Urology and Nephrology –
Online First- DOI: 10.1007/s11255-010-9836-2

Aydin Unal, Ismail Kocyigit, Murat Hayri Sipahioglu, Bulent Tokgoz, Oktay Oymak and Cengiz Utas

Abstract

Aim To evaluate the patients transferred from one dialysis modality to another and to compare the patient characteristics on both renal replacement modalities.

Patients and method The data of dialysis patients, who were followed up between January 2000 and December 2009 in our nephrology department, was evaluated retrospectively. Fifty-seven patients were transferred from HD to PD (Group 1) and 94 patients were transferred from PD to HD (Group 2) were included in this study. We recorded patients demographic, clinical, and laboratory findings, and
the cause of transfer from HD to PD or from PD to HD.

Results The mean age of the patients was 52.1 ¡¾ 4.1 years. Eighty-four of the 151 patients were men and 67 were women. The etiology of end-stage renal failure was diabetes mellitus and hypertension in most of the patients. The causes of transfer from HD to PD were vascular access problems in 37 (64.9%), patient preference in 8 (14.0%), cardiovascular
problems in 7 (12.3%), inadequate dialysis in 4 (7.0%) patients, and unknown in 1 (1.8%) patient. On the other hand, the causes of transfer from PD to HD were refractory peritonitis in 61 (64.9%), catheter-related problems in 14 (14.9%), inadequate dialysis in 8 (8.5%), increased intraabdominal pressure-related problems in 7 (7.4%), patient
preference in 2 (2.1%), and ultrafiltration failure in 2 (2.1%) patients. Alkaline phosphatase and calcium ¡¿ phosphorus products were significantly higher in Group 1 compared to Group 2. The presence
of diabetes mellitus, Kt/Vurea, and 24-h residual urine volume were significantly higher in Group 2 than in Group 1. There was no significant difference in terms of other parameters.

Conclusion Vascular access problems were the most frequent cause of transfer from HD to PD. On the
other hand, the most frequent cause of transfer from PD to HD was refractory peritonitis. Preservation of residual urine volume was better in PD patients compared to HD patients.

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