Verger C, Ryckelynck J-P, Duman M, Veniez G, Lobbedez T, Boulanger E, Moranne O
Peritoneal Dialysis Unit, RDPLF - Dialysis Department, Hôpital René Dubos, Pontoise, France.
Kidney Int Suppl. 2006 Nov(103):S12-20. doi: 10.1038/sj.ki.5001911.
The Registre de Dialyse Péritonéale de Langue Française (RDPLF Registry) is a non-profit association that has been set up to assist physicians and nurses in evaluating their practical experience and results regarding peritoneal dialysis (PD). Five French-speaking and two Spanish-speaking countries have participated in this initiative (which includes 21 000 patients). In France, 82% of all PD patients are included in the registry and the main results for the period from 1995 to January 2006 form the basis of this report: of 11 744 incident patients with a median age of 71 years, 21.5% were over 80 years of age and 56% were not able to perform PD treatment at home without assistance. Eighty-six percent of the latter group received external assistance from a private nurse and 14% were aided by their family. The overall average rate of peritonitis was one episode every 29 months. The probability of being peritonitis-free appeared to be better for patients on automated PD (59.4% at 2 year) than for those on continuous ambulatory PD (55.3%), but this finding requires further validation. The average waiting time before transplantation was about 2 years. In patients who had undergone transplantation, the peritonitis rate was one episode per 42 months before transplantation compared to one episode per 29 months for patients who had not received a transplant. Eighty-three percent of patients had a hemoglobin level greater than 11 g%. Catheter survival was 92% at 2 years post-insertion and 85% at 5 years, with 94% being implanted by experienced surgeons. In conclusion, the RDPLF results demonstrate that PD may be successfully prescribed for older patients who receive assistance either from their family or from a nurse. Further, a larger number of younger patients should also be prescribed this technique in France. Patients eligible for transplantation and on short-term PD have the lowest risk of developing peritonitis; PD before transplantation may help prolong residual renal function, and initial treatment by PD may also help to preserve vascular access for the future.
法国腹膜透析登记处（RDPLF登记处）是一个非营利性协会，其设立目的是协助医生和护士评估他们在腹膜透析（PD）方面的实践经验和成果。五个法语国家和两个西班牙语国家参与了这一倡议（涉及21000名患者）。在法国，所有PD患者中有82%被纳入登记处，1995年至2006年1月期间的主要结果构成了本报告的基础：在11744例新发病例中，中位年龄为71岁，21.5%的患者年龄超过80岁，56%的患者无法在没有帮助的情况下在家中进行PD治疗。后一组中的86%接受了私人护士的外部帮助，14%得到了家人的帮助。腹膜炎的总体平均发生率为每29个月发生一次。自动腹膜透析患者（2年时为59.4%）无腹膜炎的概率似乎高于持续非卧床腹膜透析患者（55.3%），但这一发现需要进一步验证。移植前的平均等待时间约为2年。在接受移植的患者中，移植前腹膜炎发生率为每42个月发生一次，而未接受移植的患者为每29个月发生一次。83%的患者血红蛋白水平高于11g%。导管植入后2年的生存率为92%，5年时为85%，94%由经验丰富的外科医生植入。总之，RDPLF结果表明，对于接受家人或护士帮助的老年患者，可以成功地开出PD处方。此外，在法国，也应该为更多年轻患者开出这种治疗方法。符合移植条件且进行短期PD的患者发生腹膜炎的风险最低；移植前进行PD可能有助于延长残余肾功能，而最初采用PD治疗也可能有助于保留未来的血管通路。
