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Long-term survivors on peritoneal dialysis.
Summary
Long-term peritoneal dialysis (PD) survival is possible for high-risk patients, including diabetics and the elderly. Patients on continuous ambulatory peritoneal dialysis (CAPD) showed better outcomes with fewer complications and improved health markers over time.
Area of Science:
- Nephrology
- Internal Medicine
Background:
- Peritoneal dialysis (PD) is a treatment for end-stage renal disease.
- Understanding predialysis characteristics and long-term outcomes is crucial for patient management.
Purpose of the Study:
- To evaluate the predialysis characteristics and long-term outcomes of patients undergoing continuous ambulatory peritoneal dialysis (CAPD) for over four years.
- To identify factors associated with successful long-term PD treatment.
Main Methods:
- Retrospective review of patients initiating PD with a potential for >4 years of follow-up.
- Comparison of characteristics and outcomes between long-term survivors (LTS) and short-term survivors (STS).
Main Results:
- Forty-two percent of patients were diabetic, and 35% were over 60.
- Nineteen patients survived >4 years (LTS), with eight being diabetic and 12 male.
- LTS were younger, had less cardiac disease, but higher predialysis creatinine and lower hematocrit than STS.
- LTS experienced fewer hospitalizations, peritonitis episodes (despite higher S. aureus peritonitis), and cardiovascular events.
- Diabetic LTS had more bone fractures; both groups had weight gain and hernias.
- Improved hematocrit, hemoglobin A1c, and stable blood pressure were observed in LTS.
Conclusions:
- High-risk patients, including diabetics and the elderly, can achieve prolonged survival on PD.
- Optimized PD management can lead to favorable long-term outcomes, with improved hematological parameters.
- Careful monitoring for complications like bone fractures in diabetic patients is warranted.