Predictors and clinical features of long-term continuous ambulatory peritoneal dialysis(CAPD)
노현정; 류동렬; 한대석; 이호영; 최규헌; 강신욱; 신석균; 박형천; 유태현
Korean Journal of Nephrology (대한신장학회지)
Korean Journal of Nephrology (대한신장학회지), Vol.20(2) : 306~314, 2001
Although CAPD has become firmly established as an effective mode of renal replacement therapy, it's technique survival rate is much inferior compared to hemodialysis. To date, few patients have been main- tained on this therapy for more than 10 years. To gain insights into clinical features of patients who had maintained over 10 years on CAPD in Korea, we retrospectively compared 23 patients who survived more than 10 years on PD(Long-term survivors, LTS) and 63 patients who died(Short-term survivors, STS-died, 41 patients) or changed to hemodialysis(STS-HD, 22 patients) within 4 years of initiating PD. For all patients, age, sex, diabetic history, prior cardiac events, body weight and biochemical profiles were analyzed. 1) The LTS were younger(39.7±12.4 vs. 47.7± 12.3 vs. 60.9±13.8 years) compared with STS-HD and STS-died. 2) The LTS had less cases of DM(4.3% vs. 31.8 % vs, 61%), and had less cases of prior cardiac events(4.3% vs. 4.5% vs, 34.1%) compared with STS-HD and STS-died. Sex ratio and body weight were comparable in three groups. 3) At the initiation of PD, the LTS had higher serum creatinine(16.7rng/dL vs. 12.4mg/dL vs, 8.4mg/ dL), albumin(3.53g/dL vs. 3.27g/dL vs, 3.20g/dL) lev- els compared with STS-HD and STS-died. 4) During 10 year CAPD treatment, LTS showed relatively stable body weight except the increase of body weight for the first 2 years in female. BUN, creatinine, protein, albumin constantly increased for the first 4 years, and then started to decline by 4 th to 6 th years. In conclusion, young age, non-diabetic history, less prior cardiac events and good nutritional status can predict the long-term survival on peritoneal dialysis. The evaluation of nutritional status and nutritional support by 4 th to 6 th years may be important in maintaining long-term survival in CAPD patients.