Combination therapy: five days PD and one day HD--what are the benefits?

Other than renal transplantation, the two major treatment options for patients with stage V kidney disease are hemodialysis and peritoneal dialysis. Both therapies have advantages and disadvantages while there are obvious physical differences in the way they are delivered. In clinical practice, one typically uses one therapy at a time in patients. However, there are medical and patient lifestyle reasons why you may want to use both on a weekly basis. Early clinical experience with this approach has been encouraging. With emerging data suggesting that more frequent hemodialysis or slower ultrafiltration rates may be beneficial for the patient there are now even more compelling reasons to consider this approach. This paper reviews the published literature on combined modality therapy and suggests reasons why we may want to utilize combination therapy more often.