Murphy G, Tzamaloukas A H, Quintana B J, Gibel L J, Avasthi P S
Department of Medicine, Albuquerque Veterans Administration Medical Center, New Mexico.
Int J Artif Organs. 1989 May;12(5):303-6.
We analyzed causes and clinical associations of hemodialysis performed during the course of CAPD in 71 patients (34 diabetic) on CAPD between 1978 and 1988. Thirty seven patients had at least one hemodialysis during CAPD. Causes (multiple for some patients) included poor compliance with CAPD (20 patients), peritoneal catheter loss from infection (16 patients), and miscellaneous other conditions (18 patients). Hemodialysis rates were similar between diabetic and non-diabetic CAPD patients. Compared to non-hemodialyzed patients, CAPD patients hemodialyzed for poor compliance had higher rates of peritonitis (one episode per 8.3 patient months vs one episode per 23.4 patient months, p less than 0.001) and catheter loss (one loss per 27.7 patient months vs one loss per 112.0 patient months, p less than 0.001), and exhibited a trend towards more deaths (annual mortality 30.9% vs 14.3%, p = 0.067). Hemodialysis performed in CAPD patients because of poor compliance is associated with higher rates of peritonitis and catheter loss, and, probably, with increased mortality.
我们分析了1978年至1988年间71例接受持续性非卧床腹膜透析（CAPD）治疗的患者（其中34例为糖尿病患者）在CAPD过程中进行血液透析的原因及临床相关性。37例患者在CAPD期间至少进行了一次血液透析。原因（部分患者有多种原因）包括对CAPD依从性差（20例患者）、因感染导致腹膜导管丢失（16例患者）以及其他各种情况（18例患者）。糖尿病和非糖尿病CAPD患者的血液透析率相似。与未进行血液透析的患者相比，因依从性差而进行血液透析的CAPD患者腹膜炎发生率更高（每8.3患者月发生1次 vs 每23.4患者月发生1次，p<0.001），导管丢失率也更高（每27.7患者月发生1次 vs 每112.0患者月发生1次，p<0.001），并且死亡人数有增加趋势（年死亡率30.9% vs 14.3%，p = 0.067）。因依从性差而在CAPD患者中进行的血液透析与更高的腹膜炎发生率和导管丢失率相关，并且可能与死亡率增加有关。
