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A four-year comparison of continuous ambulatory peritoneal dialysis and home hemodialysis: a preliminary report
Insights
Continuous ambulatory peritoneal dialysis (CAPD) and home hemodialysis offer adequate dialysis. However, CAPD patients experienced higher hospitalization rates due to peritonitis, potentially impacting survival.
Area of Science:
- Nephrology
- Renal Replacement Therapy
Background:
- Dialysis is a critical treatment for end-stage renal disease.
- Continuous ambulatory peritoneal dialysis (CAPD) and home hemodialysis are established renal replacement therapies.
Purpose of the Study:
- To compare the adequacy of dialysis, morbidity, and survival between CAPD and home hemodialysis.
- To identify differences in patient outcomes between these two dialysis modalities.
Main Methods:
- Retrospective comparison of patients initiating dialysis between 1979 and 1983.
- Analysis included 30 home hemodialysis patients and 21 CAPD patients.
- Outcomes assessed: dialysis adequacy via lab studies, hospitalization days, and survival rates.
Main Results:
- Both CAPD and home hemodialysis provided adequate dialysis.
- CAPD patients had twice the annual hospitalization days compared to home hemodialysis patients, primarily due to peritonitis.
- Survival rates were similar at 32 months; deaths in the CAPD group were potentially linked to peritonitis complications.
Conclusions:
- CAPD ensures adequate dialysis but is associated with increased morbidity (hospitalization) due to peritonitis.
- Peritonitis in CAPD patients may represent a risk factor that can adversely affect patient survival.
- Home hemodialysis showed comparable survival with lower hospitalization rates.
Abstract:
All patients who received initial dialysis therapy by either continuous ambulatory peritoneal dialysis (CAPD) or home hemodialysis between January 1979 and January 1983 were retrospectively compared for adequacy of dialysis, morbidity, and survival. In this study group, 30 patients had home hemodialysis and 21 patients had CAPD; the mean ages of the patients in these two groups were comparable. Both methods of treatment provided adequate dialysis, as shown by results of serial laboratory studies. The number of days of hospitalization per year at risk was twice as great for the patients on CAPD as for those on home hemodialysis; peritonitis was responsible for this difference. The survival was similar in both groups at 32 months of therapy. Death was clearly related to coexisting morbid events other than dialysis in the home hemodialysis group; however, one of the two deaths in the group on CAPD seemed to be indirectly related to the treatment of peritonitis. These findings suggest that CAPD, when compared with hemodialysis, (1) provides adequate dialysis, (2) is accompanied by greater morbidity (hospitalization), and (3) may introduce a morbid event (peritonitis) that may adversely affect survival.