Patient and Technique Survival on Capd in Turkey

Abstract

Objective

To analyze the status of continuous ambulatory peritoneal dialysis (CAPD) in 12 centers in Turkey.

Design

Retrospective study of CAPD technique and patient outcome.

Setting

University hospital renal units.

Patients

334 patients [205 males (61%), 129 (39%) females; mean age 42.2 ± 13.8 years; mean follow-up time 23.5 ± 18.3 months] beginning CAPD between March 1992 and December 1999, and having a minimum follow-up of 3 months.

Outcome Measure

Patient survival, technique survival, and duration of hospitalization.

Results

Mean weekly Kt/V urea was 1.9 ± 0.8, weekly creatinine clearance was 62.9 ± 8.5 L/1.73 m², and mean serum albumin level was 3.7 ± 0.6 g/dL. 93 patients (28%) were withdrawn from peritoneal dialysis due to death (12.6%), transplantation (3.9%), transfer to hemodialysis (8.7%), patient failure to adapt (1.5%), and other reasons (1.2%). The major causes of death were cardiovascular disease (60%), infection (19%), malignancy (2%), and others (19%). Cox proportional hazard model analysis indicated age, serum albumin levels, comorbidity, and functional status affected survival and hospitalization (p < 0.05), whereas gender and Kt/V did not (p > 0.05). Estimation of patient survival by Kaplan–Meier analysis showed 94.2%, 88.6%, 84.5%, and 68.9% at 1, 2, 3, and 5 years respectively. Technique survival estimate by Kaplan–Meier analysis was 96.6%, 91.1%, 90.4%, and 77.4% at 1, 2, 3, and 5 years respectively.

Conclusion

Peritoneal dialysis is an acceptable method of renal replacement therapy in Turkey. There is controversy regarding the usefulness of Kt/V in predicting mortality and morbidity.