Excellent ultrafiltration and clearance after more than 12 years of peritoneal dialysis: two case reports

Because of a higher (but improving) incidence of technique failure, peritoneal dialysis (PD) is not thought to equal hemodialysis (HD) for long-term use. Other than death and transplantation, the reasons that patients leave PD include peritonitis, catheter problems, patient burnout, and (in long-duration patients) the development of encapsulating peritoneal sclerosis or ultrafiltration failure. Here, we report 2 patients who have been on continuous ambulatory PD continuously for more than 12 years, maintaining good ultrafiltration and clearances. In the case reports, we suggest potential reasons for the long duration of therapy in these women. We conclude that, in some patients on continuous ambulatory PD who sparingly use very hyperosmolar dextrose solutions and who are able to avoid frequent episodes of peritonitis, long-term PD is possible and may not require transition to HD.