Fox J G, Fowler I, Boulton-Jones J M
Renal Unit, Royal Infirmary, Glasgow, UK.
Nephrol Dial Transplant. 1993;8(3):240-3.
We have reviewed the results of continuous ambulatory peritoneal dialysis (CAPD) in a single renal unit over the period from December 1979 to the end of 1990. Case records of 211 of the 222 patients treated by CAPD over this period were obtained and age, sex, diagnoses, duration of CAPD, and cause of death determined. We found marked effects of age and a diagnosis of atheromatous vascular disease at the start of CAPD on patient survival. For patients aged under 45 years 5-year patient survival was 78%, for those aged 45-65 it was 29% and for those aged over 65 years it was 32%. Patients with a diagnosis of atheromatous vascular disease at the start of CAPD had a 3-year survival of 25% compared with 69% for age- and sex-matched CAPD patients without such a diagnosis. Five-year technique survival was 67% if failure was defined as transfer to haemodialysis or death as a direct result of CAPD, but only 11% of patients were on CAPD continuously for 5 years. Attempts to compare our results with those from other reports were hindered by the variety of methods used to calculate patient and technique survival; we suggest that standard methods should be agreed.
我们回顾了1979年12月至1990年底在单一肾脏科室进行持续非卧床腹膜透析(CAPD)的结果。获取了在此期间接受CAPD治疗的222例患者中211例的病例记录,并确定了年龄、性别、诊断、CAPD持续时间和死亡原因。我们发现,CAPD开始时的年龄以及动脉粥样硬化性血管疾病的诊断对患者存活率有显著影响。45岁以下患者的5年存活率为78%,45 - 65岁患者为29%,65岁以上患者为32%。CAPD开始时被诊断为动脉粥样硬化性血管疾病的患者3年存活率为25%,而年龄和性别匹配的无此类诊断的CAPD患者为69%。如果将失败定义为转为血液透析或因CAPD直接导致死亡,5年技术存活率为67%,但只有11%的患者持续进行CAPD达5年。由于计算患者和技术存活率所采用的方法多种多样,我们难以将我们的结果与其他报告的结果进行比较;我们建议应商定标准方法。