Heaton A, Rodger R S, Sellars L, Goodship T H, Fletcher K, Nikolakakis N, Ward M K, Wilkinson R, Kerr D N
Br Med J (Clin Res Ed). 1986 Oct 11;293(6552):938-41. doi: 10.1136/bmj.293.6552.938.
Two hundred and twenty nine consecutive patients (129 men, mean age 45) were reviewed 12 to 65 months after starting treatment with continuous ambulatory peritoneal dialysis (CAPD) from January 1979 to December 1983. They received CAPD for a mean of 19.8 (range 0.5-62) months. Actuarial patient survival was 79% at 24 months and 72% at 36 months. Half of the 46 deaths were related to cardiovascular disease, while eight patients died of abdominal complications, including three patients with peritonitis. Peritonitis occurred at a rate of one episode per 35 patient weeks, and 88% of episodes were cleared by one or more courses of antibiotics. This still left peritonitis as the commonest cause of failure of CAPD, leading to a permanent change of treatment in 44 patients and temporary interruption in a further 25. CAPD remains a reasonable medium term treatment in chronic renal failure. Despite the persisting problem of peritonitis the results are comparable with those achieved by haemodialysis, and CAPD has become the treatment of first choice for end stage renal failure in Newcastle. In younger patients judged unsuitable for transplantation and facing long term dialysis, however, haemodialysis is preferred.
对1979年1月至1983年12月开始接受持续性非卧床腹膜透析（CAPD）治疗的229例连续患者（129例男性，平均年龄45岁）进行了回顾性研究，观察时间为开始治疗后的12至65个月。他们接受CAPD治疗的平均时间为19.8个月（范围0.5 - 62个月）。24个月时患者的精算生存率为79%，36个月时为72%。46例死亡患者中有一半与心血管疾病有关，8例患者死于腹部并发症，其中3例死于腹膜炎。腹膜炎的发生率为每35患者周发生1次，88%的发作通过一个或多个疗程的抗生素得以清除。但腹膜炎仍是CAPD治疗失败的最常见原因，导致44例患者永久性改变治疗方式，另有25例患者暂时中断治疗。CAPD仍然是慢性肾衰竭合理的中期治疗方法。尽管腹膜炎问题仍然存在，但结果与血液透析相当，并且CAPD已成为纽卡斯尔终末期肾衰竭的首选治疗方法。然而，对于被判定不适合移植且面临长期透析的年轻患者，血液透析更受青睐。
