title: Comparison and causes of transfer from one dialysis modality to another.
abstract: OBJECTIVE
  To evaluate the patients transferred from one dialysis modality to another and to compare the patient characteristics on both renal replacement modalities.
  
  
  METHODS
  The data of dialysis patients, who were followed up between January 2000 and December 2009 in our nephrology department, was evaluated retrospectively. Fifty-seven patients were transferred from HD to PD (Group 1) and 94 patients were transferred from PD to HD (Group 2) were included in this study. We recorded patients' demographic, clinical, and laboratory findings, and the cause of transfer from HD to PD or from PD to HD.
  
  
  RESULTS
  The mean age of the patients was 52.1 ± 14.1 years. Eighty-four of the 151 patients were men and 67 were women. The etiology of end-stage renal failure was diabetes mellitus and hypertension in most of the patients. The causes of transfer from HD to PD were vascular access problems in 37 (64.9%), patient preference in 8 (14.0%), cardiovascular problems in 7 (12.3%), inadequate dialysis in 4 (7.0%) patients, and unknown in 1 (1.8%) patient. On the other hand, the causes of transfer from PD to HD were refractory peritonitis in 61 (64.9%), catheter-related problems in 14 (14.9%), inadequate dialysis in 8 (8.5%), increased intraabdominal pressure-related problems in 7 (7.4%), patient preference in 2 (2.1%), and ultrafiltration failure in 2 (2.1%) patients. Alkaline phosphatase and calcium × phosphorus products were significantly higher in Group 1 compared to Group 2. The presence of diabetes mellitus, Kt/V(urea), and 24-h residual urine volume were significantly higher in Group 2 than in Group 1. There was no significant difference in terms of other parameters.
  
  
  CONCLUSIONS
  Vascular access problems were the most frequent cause of transfer from HD to PD. On the other hand, the most frequent cause of transfer from PD to HD was refractory peritonitis. Preservation of residual urine volume was better in PD patients compared to HD patients.
authors.affiliation: Department of Internal Medicine, Nephrology Division, Erciyes University Medical School, Kayseri, Turkey. aydinunal2003@gmail.com
authors.forename: Aydin
authors.initials: A
authors.lastname: Unal
authors.forename: Ismail
authors.initials: I
authors.lastname: Kocyigit
authors.forename: Murat Hayri
authors.initials: MH
authors.lastname: Sipahioglu
authors.forename: Bulent
authors.initials: B
authors.lastname: Tokgoz
authors.forename: Oktay
authors.initials: O
authors.lastname: Oymak
authors.forename: Cengiz
authors.initials: C
authors.lastname: Utas
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D006435:Renal Dialysis / Q000379:methods*; D012189:Retrospective Studies