Weber J, Mettang T, Mayer-Wehrstein R, Kuhlmann U
Abteilung für Nephrologie und Rheumatologie, Zentrum für Innere Medizin, Robert-Bosch-Krankenhaus, Stuttgart.
Dtsch Med Wochenschr. 1991 Apr 26;116(17):641-8. doi: 10.1055/s-2008-1063660.
From 1979 to 1989, continuous ambulatory peritoneal dialysis (CAPD) was undertaken for terminal renal failure in 104 patients (56 women and 48 men; average age 54 +/- 15.3 years at the onset of dialysis), for a total observation period of 175 patients years. Survival rate for patients and methods and dialysis effectiveness were analysed retrospectively, the incidence of peritonitis prospectively, 40 patients were aged 60 years and over. Diabetic nephropathy was the most common cause of terminal renal failure (44%). Cumulative patient survival rate was 80% in the first year of treatment; 57% of patients were still alive after two years. The cause of death in 45 of the 54 patients who had died was unrelated to CAPD, cardiac disease and cerebrovascular accident being the most frequent causes (n = 26). During the first treatment year 47% of patients contracted bacterial peritonitis, 59% during the first two years. In 9% of patients CAPD had to be discontinued within the first two treatment years because of CAPD-related complications. There was no case of sclerosing peritonitis or of ultrafiltration loss forcing CAPD termination. These data indicate that there is no plausible explanation from a medical viewpoint for the highly restrictive use of CAPD in the Federal Republic of Germany.
1979年至1989年期间，对104例终末期肾衰竭患者（56例女性，48例男性；透析开始时平均年龄54±15.3岁）进行了持续性非卧床腹膜透析（CAPD），总观察期为175患者年。对患者的生存率、治疗方法及透析效果进行回顾性分析，对腹膜炎发病率进行前瞻性分析，其中40例患者年龄在60岁及以上。糖尿病肾病是终末期肾衰竭最常见的病因（44%）。治疗第一年患者累积生存率为80%；两年后57%的患者仍存活。54例死亡患者中有45例的死因与CAPD无关，心脏病和脑血管意外是最常见的死因（n = 26）。在治疗的第一年，47%的患者发生细菌性腹膜炎，头两年为59%。9%的患者在治疗的头两年内因与CAPD相关的并发症而不得不停止CAPD治疗。没有发生硬化性腹膜炎或超滤丧失导致CAPD终止的病例。这些数据表明，从医学角度来看，在德意志联邦共和国对CAPD的高度限制性使用没有合理的解释。
