[Survival of patients with diabetic nephropathy on continuous ambulatory peritoneal dialysis. Own experiences]

We analyzed 5 years survival on CAPD diabetics with respect to the type of diabetes (D). There were 24 pts with type 1 D, 13 pts with type 2 D and 29 non diabetic CAPD pts (for comparison of long-term survival). In the D groups we analyzed adequacy of dialysis, nutritional status (albumin level), frequency of peritonitis (PN) as well as character and progression of cardiovascular complications. Patients with type 2 D were older (58.46 +/- 8.54 yrs), had lower initial level of albumin's in serum (3.3 +/- 1.0 g/dl), more cardiovascular complications at the start of CAPD. Survival of 1st 3rd, and 5th year of CAPD was achieved respectively in 89%, 70.8% and 58.3% of type 1 D; in 100%, 69% i 38.5% of type 2 D; and in 96.5%, 72.4% i 65.5% of the control group of non diabetics. Despite similar adequacy of CAPD (Kt/V 2.14 +/- 0.62 vs 2.08 +/- 0.36; weekly CrCI 64.15 +/- 16.1 vs 62.08 +/- 12.72 ml/min/1.73 sq.m) and low ratio of PN (1:30.6 vs 1:32.7 ptsmnths) cardiovascular complications progressed in both groups of D, especially in type 2, being responsible for death of 3/24 pts with type 1 D and 8/13 pts with type 2 up to 5th year of observation. Because of progressive character of cardiovascular complications and high ratio of death especially in diabetes type 2 despite adequate dialysis, we recommend early referral of predialysis diabetics to nephrologist as well as earlier start of CAPD with simultaneous application for kidney or kidney and pancreas transplantation.