Passadakis P, Thodis E, Vargemezis V, Oreopoulos D
Department of Nephrology, Medical School, Democritus University of Thrace, Greece.
Adv Perit Dial. 2000;16:59-66.
Only a small number of peritoneal dialysis (PD) patients with diabetes have been followed for more than 5 years. Lack of extended follow-up for these patients is largely due to coexisting, far-advanced damage to target organs at initiation of dialysis, with progression of that damage during the course of dialysis; the presence of various comorbid conditions at the start of dialysis; and limits to long-term PD technique. Among renal replacement modalities, continuous ambulatory peritoneal dialysis (CAPD) has been favored by many clinicians for the treatment of diabetic patients owing to reasons inherent in the therapy. Reported survival rates of diabetic patients on CAPD vary from 17%-72% for the fourth year (mean value: 39%) and from 19%-63% for the fifth year (mean value: 35%). Diabetic patients have actuarial rates of patient survival and technique survival that are lower than those for non diabetic patients of comparable age on CAPD. Patient survival for diabetic patients undergoing PD is similar to that for diabetic patients on hemodialysis. Because the peritoneal membrane maintains its ability to adequately purify blood for a long time, CAPD remains a viable form of long-term renal replacement therapy for diabetic patients with end-stage renal disease.
仅有少数糖尿病腹膜透析（PD）患者接受了超过5年的随访。这些患者缺乏长期随访主要是由于透析开始时并存的、进展到晚期的靶器官损害，以及透析过程中损害的进展；透析开始时存在各种合并症；以及长期腹膜透析技术的局限性。在肾脏替代治疗方式中，由于治疗本身的原因，持续非卧床腹膜透析（CAPD）受到许多临床医生的青睐，用于治疗糖尿病患者。据报道，接受CAPD治疗的糖尿病患者第4年的生存率在17%至72%之间（平均值：39%），第5年的生存率在19%至63%之间（平均值：35%）。糖尿病患者的实际生存率和技术生存率低于接受CAPD治疗的年龄相仿的非糖尿病患者。接受腹膜透析的糖尿病患者的生存率与接受血液透析的糖尿病患者相似。由于腹膜长期保持充分净化血液功能的能力，CAPD仍然是晚期肾病糖尿病患者长期肾脏替代治疗的一种可行方式。
