LONG-TERM CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS

Of 174 patients who entered our CAPD program, 58 received transplants, 7 were transferred to another center, one recovered satisfactory kidney function, 22 were transferred to hemodialysis, 24 to IPD, 52 died and 10 remained on CAPD for at least seven years, when this study was completed. These 10 patients (8 women and 2 men) who are described here in detail had a median age of 46 (range of 24 to 63) years at entry. Their primary renal disease was glomerulonephritis (6), polycystic kidney disease (2), nephrosclerosis (1) and Alport's disease (1). They spent 91 to 134 (average 113) months on CAPD. They had a significant (p = 0.025) increase in body weight from 54.5 +/- 2.8 kg to 59.6 +/- 3.0 kg during the first 3 years, and a decrease in ultrafiltration capacity; BUN and serum creatinine remained relatively stable. Mean total protein and serum albumin remained unchanged at 65 and 35 g/l respectively, throughout the study. There were no significant changes in the hemoglobin and lipid values. Renal osteodystrophy progressed slowly. Peritonitis rate in this group was one episode every 18.9 patient months. These 10 patients had a total of 25 catheters implanted during the study period. The average hospitalization rate was 8.76 days per patient year, 5.34 of which were for peritonitis. Of these 10 patients, one was transferred to hemodialysis, 5 died (4 of or during peritonitis, one of myocardial infarction) and 4 remained on CAPD. Our experience with these 10 patients indicates that CAPD can be carried out over long periods. This long patient/technique survival may be due to their relative young age and the absence of hypertension and other cardiovascular complications at entry. They are also proof that the peritoneal membrane can maintain its dialysis and ultrafiltration capacity over many years.