Is CAPD an effective treatment for ESRD patients with a weight over 80 kg?
We studied the effectiveness of CAPD in large patients (> 80 kg) (group B, n = 49) by comparing them to a group of patients whose body weight was 60-80 kg (group A, n = 193). Patients in group B were two years younger (55.4 versus 57.7 years, p < 0.01), were predominantly male (M: F ratio 33/16 vs 84/109) and had slightly higher residual creatinine clearance (8 ml/min vs 6 ml/min) at the beginning of treatment. The prevalence of diabetes and the prevalence of comorbid conditions in the two groups were similar. The incidence of peritonitis was similar between the two groups. Patients with a large weight spent significantly fewer days in hospital (20.6 +/- 25 vs 23.4 +/- 35.0 days/year); reasons for hospitalization were similar, except for weakness/fatigue that was more frequent (10%) in group B than in group A (2%). The initial weekly dialysate volume was similar in the two groups (57 +/- 51 in group B and 56 +/- 101 in group A) and increased in both groups at the end of the study to 60 +/- 141 in group B and 61 +/- 171/week in group A. The weight of 6 patients in group B and 5 in group A decreased below the range of that group. On the contrary the weight of 28 patients in group A increased to the range of group B. Based on the final weight there were 166 patients whose weight was 60-80 kg, and 71 patients whose weight was over 80 kg (80-109 kg). Patient survival was similar between the two groups. There was a significantly higher death rate among those patients whose weight decreased in both groups compared to those whose weight increased or remained stable. We conclude that CAPD is an effective treatment in the management of ESRD patients with weights over 80 kg. There is a high mortality among patients whose weight decreases irrespective of their initial weight.
Afthentopoulos
I E
IE
Toronto Hospital, Ontario, Canada.
Oreopoulos
D G
DG
D001835:Body Weight; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000401:mortality; D010531:Peritoneal Dialysis, Continuous Ambulatory; D015996:Survival Rate; D015431:Weight Loss