Abstract
Of 26 diabetic patients starting CAPD before July 1, 1981, six had survived over five years on this mode of dialysis. Considering as “withdrawn alive” those who received transplants or switched to hemodialysis, the one and five-year survival was 70% and 44% respectively. The six type I diabetics who survived over five years were young (mean age 31.8 ± 2 years at onset of CAPD), initially free of cardiac disease and predominantly non-smokers. On CAPD they had relatively low hospitalization rates, including admissions for peritonitis, and a peritonitis rate of one episode every 13.6 patient months. Blood pressure improved but most required therapy at five years. Vision was maintained, but four of six had bone fractures. Serum cholesterol increased with time; one patient had a silent myocardial infarct and two developed angina. As assessed by HgA1c, blood glucose control improved over predialysis values. Four of these six maintained their physical activities and two deteriorated. These results demonstrate that diabetic patients can survive for a long period on CAPD. We suggest that attention be focused on cardiac risk factors and that diabetic patients be encouraged to abstain from smoking.
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