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REVIEWS AND ORIGINAL ARTICLES |
The Department of Medicine, Nephrology Section, University of Antioquia School of Medicine and the Renal Unit, Hospital, Universitario San Vincente de Paul, Medellin, Colombia, South America
Correspondence to: Gonzalo Mejia, Ap. Aereo 60417, Me dellin, Colombia, South America.
Our continuous ambulatory peritoneal dialysis (CAPD) program consists of
three 2-L daily exchanges (usually two of 1.5% and one of 4.25% dextrose
concentration). Between March 1981 and November 1987, 87 patients were started
on this program. Mean age was 35 years, 55% were males, and mean follow-up was
20.1 ± 2 months for a total experience of 1748 patient months. At the
end of the study, 27 (31%) were still on CAPD, 43 (49.5%) had received renal
transplants, 8 (9.2%) had returned to hemodialysis, 6 (6.9%) had been
transferred to other units, 2 (2.3%) died, and 1 (1.1%) voluntarily quit.
Actuarial survival rates were 90%, 81 %, and 57% for patients, method, and
catheters, respectively, at 66 months. Peritonitis appeared at a rate of one
episode per 14 patient months for a total of 121 episodes occurring in 51
patients. Rates of other complications were not higher than those reported by
others. Hospitalization rates were low. Hypertension improved, patient weight
did not change, and laboratory data tended towards normal levels or
normalized. In selected patients, three 2-L exchanges per day appear to be
enough for an adequate CAPD, even for long-term treatment. At the same time,
it allows a 25% reduction in cost and risk of peritonitis. Larger number of
patients and longer follow-up periods will be required to exactly define its
real usefulness and safety.
KEY WORDS: Three daily exchanges; long-term followup; survival; complications; peritonitis.
Received 7 March 1988; accepted 21 April 1988.
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