Hybrid Dialysis Outcomes in Qatar: 3-Year Experience

Background: Hybrid Dialysis is a combined dialysis modality using both Hemodialysis and Peritoneal dialysis. Methods: PD patients with either low solute clearance or inadequate UF despite using the maximum applicable PD regimen were identified. We enrolled twenty-three patients (May 2021-April 2024). All of them were kept on once-weekly HD plus the current PD regimen 6 days per week. We evaluated volume status clinically. Pre-HD urea, potassium, phosphorus, and bicarbonate as indicators of solute clearance, and Albumin level as an indicator of nutritional state. In addition to dialysis catheter-related complications, patient satisfaction and finally checking outcomes. Results: A significant improvement in volume status was associated with a reduction in mean Systolic Blood Pressure (174 ± 32 Vs 135± 15 mmHg, p < 0.0001). All solute clearance indicators showed significant improvement. Reduction in mean urea by 36.7% p-value < 0.001, mean potassium by 23.52% p-value <0.0001, and mean phosphorus reduction of 26.5 % p-value <0.01. The rise in mean bicarbonate was by 15.6 % p-value < 0 .001. Improvement of mean serum albumin p-value <0.05 was observed . Patient satisfaction index was improved. Five patients (21.7%)shifted to Hemodialysis, Five Patients (21.7%), returned to Peritoneal dialysis, three patients (13%) underwent a kidney transplant, two patient leave the country and eight patients (34.8 %) still doing Hybrid dialysis some of them started more than 25 months, average staying was 16 months. Conclusion: Hybrid dialysis is a reasonable dialysis model for patients with frequent volume overload, low solute clearance, or both on PD with significant improvement in volume status, Solute clearance, nutritional status, and patient satisfaction. Hybrid dialysis can be used for more than 24 months. Some patients can return to full PD most of them were started due to volume overload. A larger number of patients and is required to generalize the findings of these observations.