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Nine patients treated for more than 10 years with continuous ambulatory peritoneal dialysis
A F Vecchi1, M Maccario, A Scalamogna
1Divisione di Nefrologia e Dialisi, IRCCS, Ospedale Maggiore di Milano, Italia.
Insights
Long-term continuous ambulatory peritoneal dialysis (CAPD) can be effective for patient survival and catheter longevity. However, after 10 years on CAPD, survival rates decline, and morbidity increases significantly.
Area of Science:
- Nephrology
- Internal Medicine
Background:
- Continuous ambulatory peritoneal dialysis (CAPD) is a treatment for end-stage renal disease.
- Long-term outcomes and survival rates for CAPD patients are critical for treatment planning.
Purpose of the Study:
- To evaluate the clinical outcomes of patients surviving over 10 years on CAPD.
- To assess the long-term effectiveness and complications of CAPD.
Main Methods:
- Retrospective analysis of 9 patients with over 10 years of CAPD treatment.
- Evaluation of hospitalization rates, peritonitis, exit-site infections, and catheter survival.
- Assessment of KT/V and peritoneal permeability using the peritoneal equilibration test.
Main Results:
- Patients experienced low hospitalization (0-4.5 days/patient/year) and peritonitis rates (1 episode/57 months).
- Six patients remained peritonitis-free for the first 10 years; 4 catheters were removed from 6 patients.
- Five patients died between 121-149 months; 4 remain alive, with 3 working.
Conclusions:
- CAPD can be an effective long-term dialysis option with good catheter survival.
- Extended CAPD treatment (over 10 years) is associated with reduced survival and increased morbidity.
- Patient selection and management are crucial for optimizing long-term CAPD outcomes.
Abstract:
We have retrospectively examined the clinical outcomes of the 9 patients who survived for more than 10 years in our continuous ambulatory peritoneal dialysis (CAPD) program. Six were men and 3 women aged 50.8 +/- (SD) 11.5 years. Three had been previously treated by hemodialysis. None of them had diabetes or neoplasms, 1 had liver cirrhosis, 3 had ischemic cardiopathy, 1 had peripheral artery disease, and all were hypertensive. The hospitalization rate ranged from 0 to 4.5 days/patient/year, the peritonitis rate was one episode every 57 months. Six patients had no peritonitis during the first 10 years of treatment. Exit-site episodes were one every 46.7 patient months. Six peritoneal catheters were removed from 4 patients. KT/V and peritoneal permeability, assessed by the peritoneal equilibration test, were within the normal range in the majority of the patients. Five patients died between the 121st and the 149th month, and 4 are still alive. Three of them are working. These results show that CAPD can be effective, peritoneal catheters can survive, and some patients can be free from peritonitis episodes for more than 10 years. After the 10-year on CAPD, the survival is poor, and the morbidity is high.