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Long term peritoneal dialysis--is it a reality?
1Department of Renal Medicine, Manchester Royal Infirmary, UK. rgokal@renal.cmht.nwest.nhs.uk
Journal of Nephrology
|January 8, 2000
Summary
Peritoneal dialysis (PD), including continuous ambulatory peritoneal dialysis (CAPD), shows comparable patient survival to hemodialysis (HD) in the medium term. Addressing PD challenges like membrane changes and peritonitis is key for improving long-term outcomes.
Area of Science:
- Nephrology
- Renal Replacement Therapy
- Dialysis Techniques
Background:
- Peritoneal dialysis (PD) use has surged in recent decades, coinciding with advancements like continuous ambulatory peritoneal dialysis (CAPD).
- Improvements in PD outcomes have been observed, with medium-term patient survival matching hemodialysis (HD).
Purpose of the Study:
- To evaluate the current status and future potential of peritoneal dialysis in renal replacement therapy.
- To discuss the advantages of initiating renal replacement therapy with PD.
Main Methods:
- Comparative analysis of patient survival and technique survival between PD and HD.
- Identification of problem areas and emerging developments in PD therapy.
Main Results:
- No significant difference in patient survival between CAPD and HD up to five years.
- PD technique survival is improving but remains lower than HD.
- Peritoneal membrane changes, residual function decline, and peritonitis are key challenges for long-term PD success.
Conclusions:
- PD offers a viable initial renal replacement therapy option.
- Further advancements are needed to overcome PD limitations and enhance long-term patient survival.
- Optimizing PD management is crucial for maximizing its benefits in renal care.