Rottembourg J, Remaoun M, Maiga K, Bellio P, Issad B, Boudjemaa A, Cossette P Y
Hypertension. 1985 Nov-Dec;7(6 Pt 2):II125-30. doi: 10.1161/01.hyp.7.6_pt_2.ii125.
From August 1978 to December 1983, 51 insulin-dependent diabetic patients with end-stage renal disease were selected for treatment by continuous ambulatory peritoneal dialysis. There were 27 male and 24 female patients, with a mean age of 52.3 +/- 13.5 years. Forty-five patients dialyzed themselves by continuous ambulatory peritoneal dialysis and six were treated by continuous cyclic peritoneal dialysis. All patients were treated at home. The cumulative duration of treatment was 65.6 patient-years; 14 patients were dialyzed for at least 24 months. Extrarenal complications were frequent at start of continuous ambulatory peritoneal dialysis, including hypertension in 48 patients, proliferative retinopathy in 50, and cardiovascular complications in 30. Age appeared to be the major risk factor, with success rates at 2 years of 78% in patients under age 50 years and only 50% in patients over age 50. The main cause of death was vascular and the main cause of transfer to other therapeutic modalities was abdominal complications or malnutrition or both. Excellent control of blood pressure, uremia, and blood glucose levels was obtained on a daily program of four exchanges. Improvement in visual status was frequently observed, mainly in the young population. In patients with juvenile diabetes, continuous ambulatory peritoneal dialysis should be part of an integrated program with transplantation, while in the elderly, the method offers a unique opportunity for them to treat themselves at home.
1978年8月至1983年12月，选取51例终末期肾病的胰岛素依赖型糖尿病患者，采用持续非卧床腹膜透析进行治疗。其中男性27例，女性24例，平均年龄52.3±13.5岁。45例患者采用持续非卧床腹膜透析自行透析，6例采用持续循环腹膜透析治疗。所有患者均在家中接受治疗。累计治疗时间为65.6患者年；14例患者透析至少24个月。在开始持续非卧床腹膜透析时，肾外并发症很常见，包括48例高血压、50例增殖性视网膜病变和30例心血管并发症。年龄似乎是主要危险因素，50岁以下患者2年成功率为78%，50岁以上患者仅为50%。主要死亡原因是血管病变，转至其他治疗方式的主要原因是腹部并发症或营养不良或两者皆有。通过每日4次交换的方案，血压、尿毒症和血糖水平得到了良好控制。视力状况改善经常可见，主要见于年轻人群。对于青少年糖尿病患者，持续非卧床腹膜透析应成为与移植相结合的综合治疗方案的一部分，而对于老年人，该方法为他们提供了在家中自我治疗的独特机会。
