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REVIEWS AND ORIGINAL ARTICLES |
From the Department of Medicine, Peritoneal Dialysis Program, Nephrology Section, and School of Pharmacy, University of Wisconsin Center for Health Sciences.
Of 26 diabetic patients starting CAPD before July 1, 1981, six had survived
over five years on this mode of dialysis. Considering as "withdrawn
alive" those who received transplants or switched to hemodialysis, the
one and five-year survival was 70% and 44% respectively. The six type I
diabetics who survived over five years were young (mean age 31.8 ± 2
years at onset of CAPD), initially free of cardiac disease and predominantly
non-smokers. On CAPD they had relatively low hospitalization rates, including
admissions for peritonitis, and a peritonitis rate of one episode every 13.6
patient months. Blood pressure improved but most required therapy at five
years. Vision was maintained, but four of six had bone fractures. Serum
cholesterol increased with time; one patient had a silent myocardial infarct
and two developed angina. As assessed by HgA1c, blood glucose control improved
over predialysis values. Four of these six maintained their physical
activities and two deteriorated. These results demonstrate that diabetic
patients can survive for a long period on CAPD. We suggest that attention be
focused on cardiac risk factors and that diabetic patients be encouraged to
abstain from smoking.
KEY WORDS: Diabetes mellitus; Continuous ambulatory peritoneal dialysis.
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