Hybrid dialysis: Two modalities twice the benefit?

Area of Science:

• Nephrology
• Renal Replacement Therapy

Background:

• Peritoneal dialysis (PD) is a preferred renal replacement therapy offering independence and cost-effectiveness compared to hemodialysis (HD).
• PD technique failure, due to loss of kidney or peritoneal membrane function, often necessitates a transition to HD.
• Hybrid dialysis (combining PD and HD) presents a potential alternative to standard HD for patients transitioning from PD.

Purpose of the Study:

• To review existing data on health and economic outcomes for patients transitioning from PD alone to hybrid dialysis (PD and HD).
• To inform patient selection, dialysis prescription, and quality evaluation for hybrid dialysis.
• To address the lack of current guideline advocacy for hybrid dialysis due to limited evidence.

Main Methods:

• Narrative review of existing literature.
• Summarization of health and economic outcome data.
• Analysis of benefits, safety, and cost of combined PD and HD.

Main Results:

• Hybrid dialysis may be a viable option for patients experiencing PD failure.
• Evidence on the specific benefits, safety, and cost-effectiveness of hybrid dialysis requires further investigation.
• Current clinical guidelines do not widely advocate for hybrid dialysis.

Conclusions:

• Hybrid dialysis warrants consideration as a patient-centered approach for individuals transitioning from PD.
• Further research and evidence are needed to support the integration of hybrid dialysis into clinical practice guidelines.
• This review provides a foundation for understanding the outcomes associated with hybrid dialysis.