Need for evidence on long-term prognosis of PD+HD: a commentary

Abstract

Combination therapy with peritoneal dialysis and hemodialysis (PD+HD) is an alternative dialysis method for patients with end-stage kidney disease (ESKD). The complementary use of once-weekly HD expedites to achieve adequate dialysis and enables to prolong PD duration. Although PD+HD has been widely employed among Japanese PD patients, it is much less common outside Japan. Clinical evidences are still not enough, especially in long-term prognosis and appropriate treatment duration, suitable patients, and generalizability. A retrospective cohort study by Chung et al. (BMC Nephrol 21:348, 2020) compared the risk of mortality and hospitalization between PD patients who were transferred to PD+HD and those who were transferred to HD in Taiwan. Because the mortality and hospitalization rates did not differ between the groups, the authors concluded that, PD+HD may be a rational and cost-effective treatment option. It should be noted that the effects of PD+HD on long-term prognosis are still unknown due to too-short PD+HD duration. However, the study identified the high-risk patient population and showed the generalizability of PD+HD. PD+HD is a treatment of choice in patients with ESKD who prefer PD lifestyles even after decline in residual kidney function.

Peritoneal Dialysis for Potential Kidney Transplant Recipients: Pride or Prejudice?

“…Even though several studies have demonstrated that PD does not exert any negative impact on transplant-related outcomes [31][32][33], some clinicians remain reluctant to propose this dialysis option to patients on the transplant waiting list (TWL) [34,35]. Such an attitude is certainly questionable since ICHD, home HD (HHD), and PD should not be regarded as competitive modalities, rather as complementary strategies before [36][37][38][39] and after transplant [40][41][42][43]. Indeed, RRT must be tailored to the specific needs and characteristics of the patient, taking into account the time-dependent variability of these parameters and local facilities [44].…”

MIDCAN: A multiple input deep convolutional attention network for Covid-19 diagnosis based on chest CT and chest X-ray

“…COVID-19 (also known as coronavirus) pandemic is an ongoing infectious disease caused by severe acute respiratory syndrome (SARS) coronavirus 2 [1] . As of 13/May/2021, there are over 161.14m confirmed cases and over 3.34m deaths attributed to COVID-19.…”