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Six Years' Experience of CAPD at One Centre: A Survey of Major Findings

Department of Renal Medicine, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden

Correspondence to: Anders Tranaeus, M.D., Karolinska Institute, Department of Nephrology, K56, Huddinge University Hospital, S-141 86 Sweden.

This study summarizes the overall experience of the first six years of CAPD treatment at one centre, during which time all patients (n = 124) were selected, trained, and treated in a uniform way. Patient selection was largely influenced by a high transplantation activity. The patients had a high mean age, 54 years at start of CAPD, and there was a high proportion of diabetics, 26%.

Patient survival was 81% after two years and 60% after four years for all patients, and 100% after four years for non-diabetic patients < 50 years of age. Patient and technique survival was significantly superior in younger non-diabetics than in diabetics and in non-diabetics &ge; 60 years. Thirty-nine percent of transfers to other forms of dialysis were due to peritonitis. The main reason for a high early discontinuation rate was transplantation.

The mean treatment time in hospital was 27.7 d per patient year, one-third of which was attributable to peritonitis. The risk of developing peritonitis within the first year on CAPD was 55%.

During CAPD, serum urea remained unchanged, serum potassium, creatinine, and uric acid levels increased, and serum albumin levels decreased. These findings suggest that patients being treated with four 2 L exchanges Id, may not be sufficiently dialyzed as the residual renal function deteriorates, thereby increasing the risk of anorexia and subsequent malnutrition.

KEY WORDS: Continuous ambulatory peritoneal dialysis (CAPD); chronic renal failure; survival; peritonitis; adequate dialysis.

Received 17 August 1987; accepted 19 October 1987.

Copyright © 1988 by Multimed Inc.