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COMPARISON OF CONTINUOUS AMBULATORY PERITONEAL DIALYSIS AND HEMODIALYSIS FOR DIABETICS

From the University of Wisconsin Department of Medicine, Madison, Wisconsin. Dr. Mejia was a visiting professor from Medellin, Colombia.

To determine the relative efficacy of hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) we compared all diabetic patients starting these treatments between April 1978 and August 1983. There were 37 HD patients and 34 CAPD patients who were comparable in age and degree of systemic disease. In the CAPD group survival was 81% at one and three years, and in the HD group 76% and 400/() at one and three years (P < 0.05) respectively. Initially CAPD patients spent more days in the hospital for catheter placement and training but subsequently had fewer hospital days. Infections other than peritonitis and catheter related were more frequent in HD (P < .05) patients, as were access repairs (P < .05). Also we compared at one year 12 patients on CAPD to eight patients on HD. Although they were comparable in all respects at the start of therapy, at the end of follow-up (24 &plusmn; 3 mo HD, 27 &plusmn; 3.5 mo CAPD) all CAPD patients remained on CAPD while only three remained on HD. Also HD patients had spent more than twice as many hospital days/patient months as did CAPD patients (P < .01). We have concluded that CAPD compares favorably with HD as a renal replacement therapy for diabetic patients at our institution.

KEY WORDS: CAPD; hemodialysis; diabetes.

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