| Comparison between Hemodialysis and Peritoneal Dialysis in Patients with End-stage Renal Disease and Liver Cirrhosis |
| Min Soo Kim, M.D., Jae Won Yang, M.D., Seung Tae Han, M.D., Jae Seok Kim, M.D. Bi Ro Kim, M.D., Byoung Geun Han, M.D. and Seung Ok Choi, M.D. |
| Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea |
| 원저 : 간경변증이 동반된 말기신부전증환자에서의 신대체 요법 |
| 김민수 양재원 한승태 김재석 김비로 한병근 최승옥 |
| 연세대학교 원주의과대학 내과학교실 |
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| Abstract |
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Purpose : During hemodialysis (HD) in patients with end-stage renal disease (ESRD) and preexisting liver cirrhosis (LC), there is a risk of inadequate ultrafiltration due to either intradialytic hypotension or a coagulopathy causing complications from alteration of clotting factors and platelets. Peritoneal dialysis has several benefits over HD for cirrhotic patients including proper hemodynamic stability, avoidance of anticoagulants and direct removal of ascitic fluid. We compared the factors associated with the survival rates in patients with ESRD and LC undergoing dialysis.
Methods : We analyzed 41 ESRD patients with LC (HD 23 patients, PD 18 patients). Their characteristics and laboratory findings at the beginning of dialysis, and survival rates were retrospectively analyzed.
Results : There was no significant difference in survival time with the treatment modality. The patients with severe ascites at the beginning of dialysis, low albumin (serum albumin <3.0 g/dL), high modified Child-Pugh score (MCP score ≥7) and low hemoglobin (Hb) level (Hb <10 g/dL) had poor survival. The multivariate analysis showed that age, the amount of ascites, the initial Hb level and the modified Child-Pugh score were risk factors for death.
Conclusion : PD was an effective renal replacement therapy for patients with ESRD and LC. Patients with a modified Child-Pugh classification of A and B were not significantly different with regard to survival rates. Therefore, PD may be a safe and effective option for patients with ESRD and LC.
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| Key Words:
Liver cirrhosis, End stage renal disease, Peritoneal dialysis |
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