Joglar F, Saade M
Department of Medicine, University of Puerto Rico School of Medicine, San Juan.
P R Health Sci J. 1996 Jun;15(2):85-90.
To analyze the clinical results of a group of young and elderly diabetic patients on ambulatory peritoneal dialysis at a large comprehensive tertiary care community hospital in San Juan, Puerto Rico in relation to rehabilitation characteristics, compliance, complications and survival.
The medical records of all patients with a diagnosis of diabetes mellitus trained between June 1985 and June 1992 were reviewed. This group of patients was subdivided according to age, in young (20-50 years) and elderly (50 or over). A comparable number of nondiabetics were selected at random for each of the two age groups.
The patient were studied for age, sex, need of assistance from a partner during dialysis, causes of transfer and hospitalizations, peritonitis, rehabilitation, patients compliance and outcome including mortality.
Young diabetics versus non-diabetics: There were 45 patients in the diabetic group (37.8% females) and 57 in the non-diabetic group (54.4% female) with a total observation time of 52.52 patient-months among the diabetics and 82.17 patient-months in the non-diabetic. Mean age of the diabetic patient was 39.9 +/- 8.8 and 36.7 +/- 8.7 for the non-diabetic. Assistance by a partner during the dialysis procedure was needed by 26.7% of the diabetics and by 3.7% of the non-diabetics (p < 0.01). Of the non-diabetics, 91.2% were classified as compliant versus 75.6% of the diabetics (p < 0.05). Peritonitis was the main cause of hospitalizations and of transfers in both groups. The two years patient survival for the diabetic was 81.7% and 100% for the non-diabetic and the two years technique survival was 32.5% for the diabetic and 43.5% for the non-diabetic. Elderly diabetics versus non-diabetics: There were 76 patients in the diabetic group (36.8% female) and 64 in the nondiabetic (43.8% female). The mean age of the diabetic group was 61.3 +/- 6.2 years and 59.3 +/- 7.3 years for the non-diabetic with a total observation time of 81.86 patients-months for the diabetic and 104.58 patient-months for the non-diabetic. Assistance by a partner during dialysis was needed in 63.5% of the diabetics and 19.45% of the non-diabetics (p < 0.01). No statistical difference was found in the rehabilitation or compliance evaluation. Peritonitis stands out again as the main cause of transfer out of the PD modality and main cause of hospitalization in both groups. The two year patient survival for the diabetic was 51.5% and 73.3% for the non-diabetic, while the two years technique survival was 49% for the diabetic and 52.9% for the non-diabetic.
A shortened technique survival, problems of compliance, a high peritonitis rate plus dependency on a partner for dialysis are features of the diabetic group. These findings demonstrate that the diagnosis of diabetes mellitus provides for the development of complications and barriers to the PD modality in both the young and the elderly.
分析在波多黎各圣胡安一家大型综合三级护理社区医院中，一组年轻和老年糖尿病患者进行非卧床腹膜透析的临床结果，内容涉及康复特征、依从性、并发症和生存率。
回顾了1985年6月至1992年6月期间所有诊断为糖尿病且接受培训的患者的病历。该组患者按年龄分为年轻组（20 - 50岁）和老年组（50岁及以上）。为两个年龄组中的每一组随机选择数量相当的非糖尿病患者。
研究患者的年龄、性别、透析期间是否需要伴侣协助、转院和住院原因、腹膜炎、康复情况、患者依从性及结果（包括死亡率）。
年轻糖尿病患者与非糖尿病患者：糖尿病组有45例患者（女性占37.8%），非糖尿病组有57例患者（女性占54.4%），糖尿病患者的总观察时间为52.52患者月，非糖尿病患者为82.17患者月。糖尿病患者的平均年龄为39.9±8.8岁，非糖尿病患者为36.7±8.7岁。26.7%的糖尿病患者在透析过程中需要伴侣协助，而非糖尿病患者中这一比例为3.7%（p<0.01）。在非糖尿病患者中，91.2%被归类为依从，而糖尿病患者中这一比例为75.6%（p<0.05）。腹膜炎是两组患者住院和转院的主要原因。糖尿病患者的两年患者生存率为81.7%，非糖尿病患者为100%；两年技术生存率糖尿病患者为32.5%，非糖尿病患者为43.5%。老年糖尿病患者与非糖尿病患者：糖尿病组有76例患者（女性占36.8%），非糖尿病组有64例患者（女性占43.8%）。糖尿病组的平均年龄为61.3±6.2岁，非糖尿病组为59.3±7.3岁，糖尿病患者的总观察时间为81.86患者月，非糖尿病患者为104.58患者月。63.5%的糖尿病患者在透析时需要伴侣协助，非糖尿病患者中这一比例为19.45%（p<0.01）。在康复或依从性评估中未发现统计学差异。腹膜炎再次成为两组患者转出腹膜透析模式的主要原因和住院的主要原因。糖尿病患者的两年患者生存率为51.5%，非糖尿病患者为73.3%；两年技术生存率糖尿病患者为49%，非糖尿病患者为52.9%。
技术生存率缩短、依从性问题、腹膜炎发生率高以及透析依赖伴侣是糖尿病组的特征。这些发现表明，糖尿病的诊断会导致年轻和老年患者出现并发症以及腹膜透析模式的障碍。
