Korean J Nephrol.  2007 Nov;26(6):705-715.

Comparison between Hemodialysis and Peritoneal Dialysis in Patients with End-stage Renal Disease and Liver Cirrhosis

• Kim MS
• Yang JW
• Han ST
• Kim JS
• Kim BR
• Han BG
• Choi SO

Abstract

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 > or =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.

Keyword

Liver cirrhosis; End stage renal disease; Peritoneal dialysis

MeSH Terms

Anticoagulants
Ascites
Ascitic Fluid
Classification
Dialysis
Hemodynamics
Humans
Hypotension
Kidney Failure, Chronic*
Liver Cirrhosis*
Liver*
Multivariate Analysis
Peritoneal Dialysis*
Renal Dialysis*
Renal Replacement Therapy
Retrospective Studies
Risk Factors
Survival Rate
Ultrafiltration
Anticoagulants