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Improving outcome of CAPD: Twenty-five years' experience in a single Korean center

DC Field Value Language
dc.contributor.author강신욱-
dc.contributor.author김범석-
dc.contributor.author이정은-
dc.contributor.author이호영-
dc.contributor.author최규헌-
dc.contributor.author최훈영-
dc.contributor.author한대석-
dc.contributor.author한승혁-
dc.date.accessioned2014-12-21T17:17:06Z-
dc.date.available2014-12-21T17:17:06Z-
dc.date.issued2007-
dc.identifier.issn0896-8608-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/97299-
dc.description.abstractBACKGROUND: Continuous ambulatory peritoneal dialysis (CAPD) is an established treatment for end-stage renal disease (ESRD). We investigated the outcome of CAPD over a period of 25 years at our institution. METHODS: CAPD has been performed in 2301 patients in 25 years. After excluding patients with less than 3 months of follow-up and missing data, we evaluated 1656 patients who started peritoneal dialysis between November 1981 and December 2005. Data for sex, age, primary disease, comorbidities, follow-up duration, cause of death, and cause of technique failure were collected. We also examined data for urea kinetic modeling (UKM), beginning in 1990, and peritonitis episodes, including causative organisms, starting in 1992. RESULTS: Compared to incident patients from 1981-1992, mean age and incidence of ESRD caused by diabetic nephropathy increased in patients from 1993 to 2005. Technique survival after 5 and 10 years was 71.9% and 48.1% respectively. Technique survival was significantly higher in patients who started CAPD after 1992 than in those who started before 1992. Peritonitis was the main reason for technique failure. Overall peritonitis rate was 0.38 episodes per patient-year, with a significant downward trend to 0.29 per patient-year over 10 years, corresponding to a decrease in gram-positive peritonitis. Patient survival after 5 and 10 years was 69.8% and 51.8% respectively. Patient survival improved significantly during 1992-2005 compared to 1981-1992 after adjustment for age, gender, diabetes, and cardiovascular comorbidities [hazard ratio (HR) 0.68, p < 0.01]. Subgroup analysis based on UKM revealed that dialysis adequacy did not affect patient survival. However, diabetes (HR 2.78, p < 0.001), older age (per 1 year: HR 1.06; p < 0.001), serum albumin level (per 1 g/dL: increase, HR 0.52; p < 0.05), and cardiovascular comorbidities (HR 2.32, p < 0.01) were identified as significant risk factors. CONCLUSION: Technique survival has improved due partly to a decrease in peritonitis, which was attributed to a decrease in gram-positive peritonitis. Patient survival has also improved considering increases in aged patients and ESRD caused by diabetes. The mortality rate of CAPD is still high in older, diabetic, malnourished, and cardiovascular diseased patients. A more careful management of higher risk groups will be needed to improve the outcome of CAPD patients in the future.-
dc.description.statementOfResponsibilityopen-
dc.format.extent432~440-
dc.relation.isPartOfPERITONEAL DIALYSIS INTERNATIONAL-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.titleImproving outcome of CAPD: Twenty-five years' experience in a single Korean center-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학)-
dc.contributor.googleauthorSeung Hyeok Han-
dc.contributor.googleauthorSang Choel Lee-
dc.contributor.googleauthorHo Yung Lee-
dc.contributor.googleauthorDae Suk Han-
dc.contributor.googleauthorKyu Hun Choi-
dc.contributor.googleauthorShin-Wook Kang-
dc.contributor.googleauthorBeom Seok Kim-
dc.contributor.googleauthorHoon Young Choi-
dc.contributor.googleauthorJung Eun Lee-
dc.contributor.googleauthorSong Vogue Ahn-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA00053-
dc.contributor.localIdA00488-
dc.contributor.localIdA03326-
dc.contributor.localIdA04043-
dc.contributor.localIdA04226-
dc.contributor.localIdA04272-
dc.contributor.localIdA04304-
dc.contributor.localIdA03119-
dc.relation.journalcodeJ02500-
dc.identifier.eissn1718-4304-
dc.identifier.urlhttp://www.pdiconnect.com/content/27/4/432.long-
dc.contributor.alternativeNameKang, Shin Wook-
dc.contributor.alternativeNameKim, Beom Seok-
dc.contributor.alternativeNameLee, Jung Eun-
dc.contributor.alternativeNameLee, Ho Yung-
dc.contributor.alternativeNameChoi, Kyu Hun-
dc.contributor.alternativeNameChoi, Hoon Young-
dc.contributor.alternativeNameHan, Dae Suk-
dc.contributor.alternativeNameHan, Seung Hyeok-
dc.contributor.affiliatedAuthorKang, Shin Wook-
dc.contributor.affiliatedAuthorKim, Beom Seok-
dc.contributor.affiliatedAuthorLee, Ho Yung-
dc.contributor.affiliatedAuthorChoi, Kyu Hun-
dc.contributor.affiliatedAuthorChoi, Hoon Young-
dc.contributor.affiliatedAuthorHan, Dae Suk-
dc.contributor.affiliatedAuthorHan, Seung Hyeok-
dc.contributor.affiliatedAuthorLee, Jung Eun-
dc.rights.accessRightsnot free-
dc.citation.volume27-
dc.citation.number4-
dc.citation.startPage432-
dc.citation.endPage440-
dc.identifier.bibliographicCitationPERITONEAL DIALYSIS INTERNATIONAL, Vol.27(4) : 432-440, 2007-
dc.identifier.rimsid50426-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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