Current issues of continuous ambulatory peritoneal dialysis

Area of Science:

• Nephrology
• Internal Medicine
• Dialysis Therapy

Background:

• Chronic continuous ambulatory peritoneal dialysis (CAPD) is a widely used treatment for end-stage renal disease (ESRD).
• Survival rates and complication profiles require ongoing evaluation, particularly in specific patient populations like those with diabetes.

Purpose of the Study:

• To assess the overall median technical survival of CAPD patients over six years.
• To reevaluate CAPD as a treatment option for diabetic ESRD patients.
• To identify and address key challenges in CAPD therapy, including infections, peritoneal function, bone disease, and malnutrition.

Main Methods:

• Retrospective analysis of CAPD patient data over a six-year period.
• Comparison of survival rates between diabetic and non-diabetic ESRD patients on CAPD.
• Evaluation of complication incidence, including peritonitis, exit site infections, and malnutrition.

Main Results:

• Diabetic ESRD patients on CAPD exhibited a 5-year survival rate, shorter than non-diabetic ESRD patients (7 years).
• Exit site/skin tunnel infections occurred at an incidence of approximately 1 episode/30 patient months.
• Malnutrition was prevalent in 26% of CAPD patients, with no significant differences in biochemical parameters between nourished and malnourished groups.

Conclusions:

• The suitability of CAPD for diabetic ESRD patients warrants reevaluation due to observed survival differences.
• Preventing exit site/skin tunnel infections is an urgent priority in CAPD management.
• Further investigation into the causes and treatment of malnutrition in CAPD patients is necessary, considering endocrinological factors.