[Continuous ambulatory peritoneal dialysis. Patient and method survival rate, peritonitis incidence and dialysis efficacy over 10 years].
From 1979 to 1989, continuous ambulatory peritoneal dialysis (CAPD) was undertaken for terminal renal failure in 104 patients (56 women and 48 men; average age 54 +/- 15.3 years at the onset of dialysis), for a total observation period of 175 patients years. Survival rate for patients and methods and dialysis effectiveness were analysed retrospectively, the incidence of peritonitis prospectively, 40 patients were aged 60 years and over. Diabetic nephropathy was the most common cause of terminal renal failure (44%). Cumulative patient survival rate was 80% in the first year of treatment; 57% of patients were still alive after two years. The cause of death in 45 of the 54 patients who had died was unrelated to CAPD, cardiac disease and cerebrovascular accident being the most frequent causes (n = 26). During the first treatment year 47% of patients contracted bacterial peritonitis, 59% during the first two years. In 9% of patients CAPD had to be discontinued within the first two treatment years because of CAPD-related complications. There was no case of sclerosing peritonitis or of ultrafiltration loss forcing CAPD termination. These data indicate that there is no plausible explanation from a medical viewpoint for the highly restrictive use of CAPD in the Federal Republic of Germany.
Weber
J
J
Abteilung für Nephrologie und Rheumatologie, Zentrum für Innere Medizin, Robert-Bosch-Krankenhaus, Stuttgart.
Mettang
T
T
Mayer-Wehrstein
R
R
Kuhlmann
U
U
D003131:Combined Modality Therapy; D005069:Evaluation Studies as Topic; D005860:Germany, West / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality / Q000628:therapy; D008875:Middle Aged; D010353:Patient Education as Topic; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects / Q000379:methods / Q000401:mortality* / Q000706:statistics & numerical data; D010538:Peritonitis / Q000453:epidemiology* / Q000209:etiology; D012074:Remission Induction; D012307:Risk Factors