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[Continuous ambulatory peritoneal dialysis. Current concepts after 10 years' experience]
1Service de Néphrologie, Groupe hospitalier Pitié-Salpêtrière, Paris.
Presse Medicale (Paris, France : 1983)
|May 20, 1989
Summary
Continuous Ambulatory Peritoneal Dialysis (CAPD) is a permanent dialysis option for end-stage renal disease. Technical advances have improved outcomes, making it comparable to hemodialysis (HD) for many patients.
Area of Science:
- Nephrology
- Renal Replacement Therapy
Background:
- Continuous Ambulatory Peritoneal Dialysis (CAPD) is a permanent dialysis alternative to hemodialysis (HD).
- CAPD is utilized by approximately 8% of renal replacement therapy patients in France.
- Significant technical advancements have enhanced CAPD therapy over the past decade.
Purpose of the Study:
- To evaluate the efficacy and safety of CAPD as a long-term treatment for end-stage renal disease.
- To compare CAPD outcomes with those of hemodialysis (HD).
- To assess the long-term performance of the peritoneal membrane in CAPD patients.
Main Methods:
- Review of technical advancements in CAPD systems, including disconnectable systems.
- Analysis of peritonitis rates and prevention strategies.
- Evaluation of ultrafiltration, nutritional status, and patient selection criteria for CAPD.
- Comparison of overall results between CAPD and HD in comparable patient groups.
- Long-term assessment of peritoneal membrane permeability and clearance.
Main Results:
- Modern disconnectable CAPD systems have reduced peritonitis rates to approximately one episode every 2-3 years.
- CAPD effectively prevents loss of ultrafiltration and sclerosing peritonitis.
- Maintaining adequate nutritional status remains a challenge in CAPD patients.
- CAPD is recommended for specific patient groups including young patients, diabetics, children, and elderly patients with stable nutrition.
- Overall results for CAPD and HD are similar in comparable end-stage renal disease patient groups.
- Long-term studies show no significant decline in peritoneal membrane permeability or clearance.
Conclusions:
- CAPD is a viable and effective long-term dialysis modality for end-stage renal disease, with improved safety profiles due to technical advancements.
- CAPD offers comparable outcomes to hemodialysis for selected patients.
- The peritoneal membrane maintains its functional performance over extended periods of CAPD treatment.