Gokal R, Jakubowski C, King J, Hunt L, Bogle S, Baillod R, Marsh F, Ogg C, Oliver D, Ward M
Royal Infirmary, Manchester.
Lancet. 1987 Nov 14;2(8568):1105-9. doi: 10.1016/s0140-6736(87)91544-3.
In a study in seven large renal units in England, the morbidity and mortality of all patients starting continuous ambulatory peritoneal dialysis (CAPD) and haemodialysis during 1983-85 were monitored prospectively over a 4-year period and related to reasons for choice of therapy and potential risk factors. 610 new patients (median age 52 years, range 3-80 years) started CAPD; 16% had diabetes mellitus and 21% cerebrovascular or cardiovascular disease. 329 patients (median age 48 years, range 5-77 years) started haemodialysis; 7% had diabetes mellitus and 17% cerebrovascular or cardiovascular disease. The Kaplan-Meier patient survival estimates at 4 years were 74% for haemodialysis and 62% for CAPD; technique survival figures for the same period were 91% for haemodialysis and 61% for CAPD. Cox's proportional hazards regression analysis showed that cerebrovascular/cardiovascular disease, age over 60 years, and diabetes mellitus were important predictors for survival in CAPD patients; there were no risk factors associated with permanent change to haemodialysis. In the haemodialysis group early change to CAPD was associated with presence of cerebrovascular or cardiovascular disease. The major cause of drop-out in both groups was transplantation. The mean length of hospital admission was 14.8 days per patient-year for CAPD and 12.4 days per patient-year for haemodialysis.
在英国七个大型肾脏单位开展的一项研究中，对1983年至1985年期间开始接受持续性非卧床腹膜透析（CAPD）和血液透析的所有患者的发病率和死亡率进行了为期4年的前瞻性监测，并分析了治疗选择原因和潜在风险因素。610名新患者（年龄中位数52岁，范围3至80岁）开始接受CAPD治疗；16%患有糖尿病，21%患有脑血管或心血管疾病。329名患者（年龄中位数48岁，范围5至77岁）开始接受血液透析；7%患有糖尿病，17%患有脑血管或心血管疾病。血液透析患者4年的Kaplan-Meier生存率估计为74%，CAPD患者为62%；同期的技术生存率数据，血液透析为91%，CAPD为61%。Cox比例风险回归分析表明，脑血管/心血管疾病、60岁以上年龄以及糖尿病是CAPD患者生存的重要预测因素；没有与转为血液透析相关的风险因素。在血液透析组中，早期转为CAPD与脑血管或心血管疾病的存在有关。两组患者退出治疗的主要原因是移植。CAPD患者的平均住院时间为每人年14.8天，血液透析患者为每人年12.4天。
