title: Self-performed peritoneal dialysis in prisoners.
abstract: Peritoneal dialysis (PD)for renal replacement therapy (RRT) is safe and effective in patients with end-stage renal disease (ESRD). Currently, no data exist for the same in patients at correctional institutions [Department of Corrections (DOC)]. We compared demographic characteristics of, and the efficacy and outcome of self-administered continuous ambulatory peritoneal dialysis (CAPD) in, DOC patients with data from the U.S. Renal Data System for the free-living population (FLP). We retrospectively reviewed the charts of DOC patients opting for CAPD (n = 10) in the last 7 years. Baseline data (age, race, cause of ESRD, serum chemistries, anemia, bone profiles, and Kt/V) were obtained for dialysis start and 6 - 12 months after dialysis start. Major events, including switches to hemodialysis (HD), hospitalizations, and deaths, were also studied. The median age of the DOC patients was 45 years. The group was 40% black, 30% white, and 30% Hispanic. Cause of renal failure was diabetes in 30%, HIV-associated nephropathy in 30%, primary glomerular disease in 20%, and hypertension or unknown in 20% of patients. The DOC patients had higher levels of blood urea nitrogen (BUN) at presentation, but better anemia profiles than did the FLP. Complications included peritonitis, fluid leaks, and cardiac events. Median age at dialysis start is lower for DOC patients, and HIV-associated nephropathy is more common than in the FLP. Levels of BUN/creatinine were much higher in DOC patients, but hemoglobin levels were similar to those in the FLP. Hospitalization rates for peritonitis were comparable; cardiac disease was common in both groups. Self-CAPD can be safely and effectively performed in DOC patients.
authors.affiliation: Division of Nephrology, Department of Medicine, University of Connecticut School of Medicine, Farmington, Connecticut 06030-1405, USA.
authors.forename: Niranjan
authors.initials: N
authors.lastname: Sankaranarayanan
authors.forename: Rachna
authors.initials: R
authors.lastname: Agrawal
authors.forename: Lori
authors.initials: L
authors.lastname: Guinipero
authors.forename: Andre A
authors.initials: AA
authors.lastname: Kaplan
authors.forename: Nancy D
authors.initials: ND
authors.lastname: Adams
mesh_terms: D000328:Adult; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects; D010538:Peritonitis / Q000209:etiology; D011329:Prisoners; D012648:Self Care