[Continuous ambulatory peritoneal dialysis. Current concepts after 10 years' experience].
Designed, in contrast with hemodialysis (HD), as a permanent dialysis procedure, CAPD progressively established itself as an accepted mode of therapy of end stage renal disease. About 8 p 100 of the total population currently undergoing renal replacement therapy in France is being treated by CAPD. Important technical advances were made over the last decade. The recent disconnectable systems reduced the rate of peritonitis down to one episode every two to three years of treatment. Loss of ultrafiltration and sclerosing peritonitis can also be efficiently prevented. Maintenance of an adequate nutritional status in the patients remains however an often difficult problem. CAPD is now preferably recommended for young patients awaiting renal transplantation, diabetics, children and also elderly patients provided a satisfactory nutritional status can be maintained over time. Although a randomized study is not practically feasible, it can be stated that HD and CAPD yield similar overall results in comparable groups of patients with end stage renal disease. Long term studies do not show any substantial decrease over time of the permeability and clearance performances of the peritoneal membrane.
Rottembourg
J
J
Service de Néphrologie, Groupe hospitalier Pitié-Salpêtrière, Paris.
Jacobs
C
C
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy; D006801:Humans; D007239:Infections / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000628:therapy*; D016030:Kidney Transplantation; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D010538:Peritonitis / Q000209:etiology; D006435:Renal Dialysis
La dialyse péritonéale continue ambulatoire. Concepts actuels après 10 années d'expérience.