Ten years experience of CAPD in diabetics: comparison of results with non-diabetics

Abstract

CAPD outcomes were compared between a group of 301 diabetic patients (mean age +/- SD, 58.9 +/- 12.7 years, 55.8% males) and a group of 1689 non-diabetic patients (mean age +/- SD 57.8 +/- 14.8 years, 55.9% males) treated in 30 centres participating in the Italian Cooperative Peritoneal Dialysis Study Group from 1980 to 1989, with follow-up observation periods of 444 years (mean +/- SD, 1.48 +/- 1.24) and of 3502 years (mean +/- SD, 2.07 +/- 1.91) respectively. CAPD was the first modality for 87.2% of diabetics and 78.1% of non-diabetics (P < 0.001). The percentage of patients who needed a partner for CAPD was 45.9% in diabetics and 30.2% in non-diabetics (P < 0.001). In diabetics compared with non-diabetics, cardiovascular diseases and cachexia were nearly twice and infections other than peritonitis more than three times as frequent in causing death. In diabetics, survival was significantly worse (P < 0.0001) and the relative risk of death 2.13 times higher (P < 0.001). The technique survival and the relative risk of drop-out were not significantly different in the two groups. Clinical problems were the most important cause of drop-out among diabetics. The probability and relative risk of drop-out due to peritonitis, as well as of the first peritonitis episode, were not significantly different between the two groups and between diabetics using or not using intraperitoneal insulin. Days per patient year of hospitalization, excluding the first, were 18.4 in diabetics and 14.3 in non-diabetics. CAPD-related problems caused hospitalization in a similar way in the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Fungal Peritonitis in Peritoneal Dialysis: Risk Factors and Prognosis

“…In other studies, it has been reported that diabetes mellitus is not a risk factor for peritonitis in PD patients. [11][12][13] In terms of time elapsed on peritoneal dialysis, there was no difference between the three groups. In some studies, time elapsed on PD is shown to have a significant impact on peritonitis frequency, [2,14] but in our study it showed no effect.…”

Quality of Life in CAPD, Transplant, and Chronic Renal Failure Patients with Diabetes

“…[5] It is known that diabetes is accompanied by multi-system and organ dysfunction, and serious questions have been raised about the outcomes (survival, morbidity) in this group of patients, in particular the impact of treatment on their quality of life. [1,6,7] There are many studies of quality of life in ESRD patients, but a limited number in patients with diabetes. [1] In the absence of prospective and longitudinal studies, quality of life in diabetic CAPD patients has only partly been examined by assessing co-morbid factors and survival, using mainly generic instruments.…”

Preocupante incremento de la diabetes como causa de insuficiencia renal terminal: Evaluación del tratamiento sustitutivo

“…Este peor pronóstico, aparece en todas las modalidades de TSFR: HD (10,20); DPCA (21,22) y trasplante renal (9,10). Los pacientes diabéticos no sólo tienen una mortalidad mayor sino que además, su morbilidad es muy alta.…”

“…Durante años, muchos nefrólogos apostaban por la diálisis peritoneal continua ambulatoria (DPCA) como el tratamiento sustitutivo de elección (12)(13)(14). En la actualidad, existen trabajos que obtienen mejores resultados con las nuevas técnicas de hemodiálisis-hemodiafiltración, y reivindican el papel beneficioso de dichos tratamientos (15). Los criterios de selección utilizados en los diabéticos para considerarlos candidatos a trasplante renal se han ampliado en los últimos años, aunque siguen sin estar totalmente claros (6,16,17).…”