Long-term follow-up of patients randomized to biocompatible or conventional peritoneal dialysis solutions show no difference in peritonitis or technique survival

Objective To compare the long-term viability of continuous ambulatory peritoneal dialysis (CAPD) to that of hemodialysis (HD). Design Retrospective study of patients of our institution starting dialysis between January 1,1981, and December 31, 1993, and surviving for at least 2 months. Patients Five hundred and seventy-eight new patients (51.3% on CAPD and 48.6% on HD). Main Outcomes Studied Cox -adjusted assessment of patient and technique survival, and of technique success. Differences in results for two successive periods of time. Results Patient survival did not differ between CAPD and HD after adjusting for age and comorbidity, and significantly improved in the second part of the follow-up (1987 -1993). Technique failure was significantly higher on CAPD, in which it was inversely related to age. The probability of a patient continuing on the first method of dialysis (“technique success”) was significantly lower on CAPD than on HD, but the difference decreased progressively with age and disappeared in patients ≥75 years. Conclusion CAPD is as effective as HD in preserving life in uremic patients in the long-term, and gives better results in the older elderly. In adults, the lower technique success rate may not be a problem for patients with access to a good transplantation program; for others, this drawback must be weighed against the advantages of home treatment.

Download Full-text

Long-term follow-up of thoracoscopic pleurodesis for hydrothorax complicating peritoneal dialysis

The Annals of Thoracic Surgery ◽

10.1016/s0003-4975(02)03648-2 ◽

2002 ◽

Vol 74 (1) ◽

pp. 218-221 ◽

Cited By ~ 24

Author(s):

Siu-ka Mak ◽

Kyaw Nyunt ◽

Ping-nam Wong ◽

Kin-yee Lo ◽

Gensy M.W Tong ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Long Term Follow Up

Download Full-text

Peritoneal Dialysis as a First versus Second Option after Previous Haemodialysis: A Very Long-Term Assessment

International Journal of Nephrology ◽

10.1155/2014/693670 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Roberto José Barone ◽

María Inés Cámpora ◽

Nélida Susana Gimenez ◽

Liliana Ramirez ◽

Sergio Alberto Panese ◽

...

Keyword(s):

At Risk ◽

Overall Survival ◽

Peritoneal Dialysis ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Individual Therapy ◽

Technique Survival ◽

Kaplan Meier

For renal replacement therapy, overall survival is more important than the choice of currently available individual therapy.Objectives. To compare patients and technique survival on peritoneal dialysis as first treatment (PDF) versus after previous haemodialysis (HDPD) and other indicators of follow-up.Methods. We prospectively studied 110 incident patients, during the period from August 4, 1993, to June 30, 2012, for patients and technique survival (Kaplan-Meier) (log rankP< 0.05).Results. Groups: (A) PDF: 37 patients, 24 females, age: 52.2 ± 14.9 years old, time at risk: 2123 patient-months (p/m), mean: 57 ± 42 months; (B) HDPD: 73 patients, 42 females, age: 52.45 ± 14.7 years old, time in haemodialysis: 3569.2 (p/m), range: 3–216 months, mean: 49 ± 45 months, time at risk in PD: 3700 (p/m), mean: 51 ± 49 months. Patients’ survival: (A) PDF: 100%, 76.6%, 65.6%, and 19.7%; (B) HDPD: 95.4%, 65.6%, 43%, and 43% at 12, 60, 120, and 144 months, respectively,P=0.34. Technique: (A) PDF: 100%, 90%, 59.8%, and 24%; (B) HDPD: 94%, 75%, 32%, and 32% at 12, 60, 120, and 144 months, respectively,P=0.40.Conclusions. Comparable patient and technique survival were observed. Peritoneal dialysis enables a greater extension of renal replacement therapy for patients with serious difficulties continuing with haemodialysis.

Download Full-text

Effective Management of Peritoneal Dialysis-Associated Hydrothorax in a Child: A Case Report

Case Reports in Nephrology and Dialysis ◽

10.1159/000506119 ◽

2020 ◽

Vol 10 (1) ◽

pp. 18-25 ◽

Cited By ~ 4

Author(s):

Cahyani Gita Ambarsari ◽

Evita Karianni Bermanshah ◽

Muhammad Arza Putra ◽

Farhan Haidar Fazlur Rahman ◽

Sudung Oloan Pardede

Keyword(s):

Peritoneal Dialysis ◽

Thoracoscopic Surgery ◽

Underlying Mechanism ◽

Long Term Follow Up ◽

Stage Renal Disease ◽

End Stage ◽

Video Assisted Thoracoscopic Surgery

Peritoneal dialysis (PD) confers many advantages, including a better quality of life for children with end-stage renal disease; however, the procedure is associated with several complications, including pleuroperitoneal leaks. Here, we report an unusual case of hydrothorax caused by long-term PD in a child, which was further complicated by pneumonia. A 9-year-old boy who had received CAPD for 22 months presented with dyspnea, swelling, and increased body weight. Chest tube drainage yielded 500 mL of transudative fluid. Computed tomography peritoneography revealed increased outflow from the peritoneum to the pleural cavity. PD was suspended, and hemodialysis (HD) was initiated. Video-assisted thoracoscopic surgery was performed; however, because the patient had pneumonia during hospitalization, pleural adhesions with a septated appearance occurred. This resulted in difficulties identifying pleuroperitoneal fistula (PPF). Right pleural effusion resolved following pleurodesis using bleomycin. Regular HD was performed for 10 weeks, and PD was subsequently reinitiated. There was no recurrence of hydrothorax during long-term follow-up. We suspect that the underlying mechanism of hydrothorax in our patient was associated with a PPF that formed either due to a congenital diaphragmatic defect or an acquired defect, resulting in dialysate leakage. Our case demonstrates that a temporary switch from PD to HD, accompanied by pleurodesis, may help resolve hydrothorax that occurs as a complication of long-term PD.

Download Full-text