Lupo A, Cancarini G, Catizone L, Cocchi R, de Vecchi A, Viglino G, Salomone M, Segoloni G, Giangrande A, Limido A
Divisione Nefrologia, Ospedale Civile Maggiore, Verona, Italy.
Adv Perit Dial. 1992;8:136-40.
We studied 1,622 patients who started regular dialysis treatment between 1985 and 1989 in 19 centers from the Italian CAPD Study Group. There were 962 pts (59%) and on HD; 660 pts (41%) on CAPD. CAPD pts were older and had more risk factors at the start than HD pts (p < 0.0001). Overall patient survival was not statistically different between CAPD and HD at 6 years (42% CAPD; 54% HD). Multivariate analysis (Cox's model) on all population revealed that age and pretreatment risk factors had a statistically significant impact on patient survival (p < 0.0001), but not the type of dialytic treatment (CAPD or HD). When multivariate analysis was applied separately by treatment modalities, in HD group age and risk factors had the same negative influence on survival (p < 0.0001) while in CAPD group the influence of age on survival was less significant (p 0.025). This multicenter study carried out with appropriate statistical methods in a large number of pts demonstrates that patients' survival at 6 years is not different on CAPD and HD (despite the worse patient selection on CAPD) and can be even better on CAPD for aged patients.
我们研究了1985年至1989年间在意大利持续性非卧床腹膜透析（CAPD）研究组的19个中心开始接受常规透析治疗的1622例患者。其中962例患者（59%）接受血液透析（HD）；660例患者（41%）接受CAPD。与HD患者相比，CAPD患者在开始治疗时年龄更大且有更多危险因素（p<0.0001）。6年时，CAPD和HD患者的总体生存率无统计学差异（CAPD为42%；HD为54%）。对所有患者进行多变量分析（Cox模型）显示，年龄和治疗前危险因素对患者生存率有统计学显著影响（p<0.0001），但透析治疗类型（CAPD或HD）无影响。当按治疗方式分别进行多变量分析时，在HD组中年龄和危险因素对生存率有相同的负面影响（p<0.0001），而在CAPD组中年龄对生存率的影响较小（p=0.025）。这项在大量患者中采用适当统计方法进行的多中心研究表明，6年时CAPD和HD患者的生存率没有差异（尽管CAPD患者的选择较差），而且对于老年患者，CAPD的生存率可能更高。
