Gloor Hans Jakob
Medizinische Abteilung, Kantonsspital Schaffhausen.
Swiss Med Wkly. 2003 Dec 13;133(45-46):619-24. doi: 10.4414/smw.2003.10202.
Few long term studies exist about peritoneal dialysis (PD). We collected the experiences over nearly 20 years in a single mid-sized centre in Switzerland.
In a retrospective survey we examined our PD-cohort with respect to mortality, technique survival, peritonitis rate and other complications. We calculated the proportion of PD-patients of the total dialysis population (penetration rate) and measured the time of PD-associated hospitalisations.
50 patients were included during an observation period of 20 years. The mean penetration rate was 23% (range 11% to 34%). The mean treatment time per patient was 2.8 years (median: 3.6 years; range 0.4-9.5 years). Patient survival was 80% at three years and 60% at five years. Technique retention rate was 40% after three, and 20% after five years. Each of the three outcome categories--transplantation, switch to haemodialysis (HD) and death during PD--accounted for one third of the PD drop-out number.
Compared to the average of Swiss dialysis centres the penetration rate is high. Patient and technique survival correspond to data in the literature, as do the frequency and types of complications. We consider PD as an efficient and well tolerated dialysis modality, which should be offered also in smaller dialysis centres. Since PD is not only feasible, but appears to be less costly than HD, we recommend PD as the first-line dialysis option for patients in end-stage renal disease.
关于腹膜透析（PD）的长期研究较少。我们收集了瑞士一个中等规模中心近20年的经验。
在一项回顾性调查中，我们对腹膜透析队列的死亡率、技术存活情况、腹膜炎发生率及其他并发症进行了研究。我们计算了腹膜透析患者在总透析人群中的比例（渗透率），并统计了与腹膜透析相关的住院时间。
在20年的观察期内纳入了50例患者。平均渗透率为23%（范围为11%至34%）。每位患者的平均治疗时间为2.8年（中位数：3.6年；范围为0.4 - 9.5年）。三年时患者生存率为80%，五年时为60%。三年后的技术保留率为40%，五年后为20%。在腹膜透析退出病例中，移植、转为血液透析（HD）和腹膜透析期间死亡这三种结局类别各占三分之一。
与瑞士透析中心的平均水平相比，渗透率较高。患者和技术生存率与文献数据相符，并发症的发生率和类型也是如此。我们认为腹膜透析是一种有效且耐受性良好的透析方式，在较小的透析中心也应提供。由于腹膜透析不仅可行，而且似乎比血液透析成本更低，我们建议将腹膜透析作为终末期肾病患者的一线透析选择。
