Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
Perit Dial Int. 2003 Dec;23 Suppl 2:S183-7.
The proportion of end-stage renal disease patients on continuous ambulatory peritoneal dialysis (CAPD) has increased by twofold in Hong Kong over last two decades, accounting for 80% of the entire dialysis population. Our encouraging outcome results--a 2-year actuarial patient survival of 83%, and a 2-year technique survival of 72.8%--further testify to the success of CAPD in our territory. A relatively constant successful outcome has been achieved despite an increasing prevalence of diabetes mellitus and an aging population. The present review postulates the reasons behind our success. Apart from reimbursement policy, technique-related factors, and center effects, inherent patient factors--including baseline survival advantage of Chinese patients, genetic difference, cardiovascular risk factors, and possibly lower dialysis volume requirement and compliance--are thought to be contributory. As for the future, more efforts are needed to further improve the technique survival rate and the nutritional status, psychosocial well-being, and rehabilitation of CAPD patients. Judicious assessment of peritoneal dialysis adequacy and preservation of residual renal function should be constantly exercised to tailor treatment to the needs of Chinese CAPD patients.
在过去的二十年中，香港接受持续非卧床腹膜透析 (CAPD) 的终末期肾病患者比例增加了一倍，占整个透析患者群体的 80%。我们令人鼓舞的结果——2 年生存率为 83%，2 年技术生存率为 72.8%——进一步证明了 CAPD 在本地区的成功。尽管糖尿病患病率增加和人口老龄化，但仍取得了相对稳定的成功结果。本综述提出了我们成功的原因。除了报销政策、技术相关因素和中心效应外，固有患者因素——包括中国患者的基线生存优势、遗传差异、心血管危险因素，以及可能较低的透析量需求和依从性——也被认为是促成因素。至于未来，需要进一步努力提高 CAPD 患者的技术生存率以及营养状况、心理社会幸福感和康复水平。应不断评估腹膜透析充分性并保留残余肾功能，以根据中国 CAPD 患者的需求定制治疗方案。
