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Ruptured Abdominal Aortic Aneurysm As a Cause of Spontaneous Hemoperitoneum in a Patient on Peritoneal Dialysis

patients, 1-year survival was 56% in those with severe LVH and 91% in those without LVH (4). Moreover, in a previous cohort of HD patients, it was demonstrated that a 10% decrease in left ventricular mass was associated with a 22% reduction in the relative risk for all-cause death and a 28% reduction for cardiovascular death (7). The 17% decrease in LVMI in our patients might have a significant impact on their survival. In patients with decreased RRF, PD+HD has several advantages. First, PD+HD may achieve PD prolongation with a minimal change in lifestyle (2,3). The combined modality is suitable for those who prefer PD, a home-based continuous therapy. Second, PD+HD may be indicated for patients with hemodynamic instability, because it reduces the frequency of HD sessions (3). Third, PD+HD may prevent excessive use of hypertonic glucose solutions, which accelerate peritoneal membrane deterioration and increase the risk of encapsulating peritoneal sclerosis (3). In addition, the combined modality may permit a “PD holiday” with peritoneal rest, which can improve quality of life and might be beneficial for maintaining peritoneal function (3). The limitations of the present study include a lack of controls, a small number of patients, and a short follow-up period. In addition, the prognosis and longterm safety of PD+HD have yet to be established. Further studies are needed to shed light on these issues. In our patients, PD+HD improved LVH, volume status, and solute removal. Combined therapy with PD+HD might be useful for patients with decreased RRF and might permit the safe prolongation of PD.