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Long-term CAPD--some U.K. experience.

R Ataman1, P R Burton, R Gokal

  • 1Department of Nephrology, Leicester General Hospital, GB.

Clinical Nephrology
|January 1, 1988
PubMed
Summary
This summary is machine-generated.

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Long-term continuous ambulatory peritoneal dialysis (CAPD) is a viable renal replacement therapy. Peritonitis remains the primary reason for transfer to hemodialysis (HD), highlighting the need for effective management strategies.

Area of Science:

  • Nephrology
  • Internal Medicine

Background:

  • Continuous ambulatory peritoneal dialysis (CAPD) is increasingly used as a first-line renal replacement therapy in the UK.
  • Understanding long-term outcomes and factors influencing CAPD success is crucial for patient management.

Purpose of the Study:

  • To evaluate the long-term outcomes of patients undergoing continuous ambulatory peritoneal dialysis (CAPD).
  • To identify factors associated with CAPD success and failure.

Main Methods:

  • A retrospective study of 177 patients who started CAPD before December 1981 across four centers.
  • Analysis included patient demographics, primary renal disease, pre- and post-CAPD clinical parameters, and survival data.
  • Cox's method of analysis was used to identify significant risk factors.

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Main Results:

  • After 4 years, 19.2% of patients remained on CAPD. 65% were alive, with 54% transferred to hemodialysis (HD), primarily due to peritonitis (2.0 episodes/patient).
  • Significant improvements were observed in hemoglobin, albumin, calcium, and creatinine levels. Activity scores decreased significantly.
  • Cardiac events and sepsis were the leading causes of mortality. Key risk factors for adverse outcomes included older age, male sex, peritonitis frequency, low activity score, and amyloidosis.

Conclusions:

  • CAPD can be a satisfactory long-term therapy for many patients, despite variations in center techniques.
  • Peritonitis is the main complication leading to transfer to HD, necessitating targeted prevention and treatment.
  • Identifying risk factors such as age, sex, peritonitis, and specific comorbidities is essential for optimizing CAPD patient selection and care.