Ultrafiltration volume by once-weekly hemodialysis is a predictor of technique survival of combination therapy with peritoneal dialysis and hemodialysis.

: Overhydration is a major cause of technique failure of peritoneal dialysis (PD). Hence, we investigated the impact of ultrafiltration (UF) volume by once-weekly hemodialysis (HD), excess volume beyond their dry weight, on technique survival of PD and HD combination therapy (PD + HD). Forty-six anuric PD + HD patients were divided into three groups according to baseline UF volume by HD: Low-UF (< mean -1SD), Middle-UF (≥ mean -1SD and < mean + 1SD), and High-UF (≥ mean + 1SD). High-UF group showed larger extracellular water normalized to height (P = 0.038) and longer HD sessions (P < 0.001) compared with Low-UF group, whereas Low-UF group was older than Middle-UF group (P = 0.001). Technique survival rate was significantly lower in High-UF group than in Low and Middle-UF groups (P < 0.001), and the rates at 44 months were 80%, 90%, 20% in Low, Middle, and High-UF groups, respectively. Chronic overhydration was the leading cause of technique failure for all. This study suggests that fluid overload remains a major cause of technique failure of PD even after once-weekly HD is added. This article is protected by copyright. All rights reserved.