Continuous ambulatory Peritoneal dialysis beyond a decade: cases from a single center.

Kanako Nobe, Tsutomu Inoue, Yuka Nodaira, Yumi Kimura, Mika Okayama, Shiko Gen, Takeru Seto, Keita Sueyoshi, Hiroshi Takane, Tsuneo Takenaka, Hirokazu Okada, Hiromichi Suzuki
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Abstract

A broad consensus has not been reached on the appropriate timing for cessation of peritoneal dialysis (PD). Decreasing urine volume, repeated and refractory peritonitis, and deterioration of the peritoneal membrane are major reasons to stop PD. Also, the link between length of time on PD and encapsulating peritoneal sclerosis (EPS) should be an additional concern. The aim of the present study was to investigate patients who had been on continuous ambulatory PD (CAPD) for a long time. All patients undergoing CAPD at our kidney center for more than a decade from January 1990 to September 2011 were included in the study. Among more than 436 CAPD patients, 11 met the inclusion criteria. Their mean PD duration was 12.3 +/- 3.1 years. Mean age at CAPD introduction had been 46.0 +/- 10.1 years. All patients had nondiabetic nephropathy as the underlying cause of their end-stage renal disease. At least 2 of the 11 had developed EPS, and 1 had subsequently died from EPS. Patients on prolonged CAPD for more than a decade are still rare. The CAPD modality may be continued if it is efficiently maintained within an acceptable level, but EPS remains a serious complication of prolonged PD.

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超过十年的连续非卧床腹膜透析:来自单一中心的病例。
关于停止腹膜透析(PD)的适当时机尚未达成广泛的共识。尿量减少、反复难治性腹膜炎、腹膜恶化是停用PD的主要原因。此外,PD治疗时间与包裹性腹膜硬化(EPS)之间的联系应该是一个额外的关注。本研究的目的是调查长期持续门诊PD (CAPD)的患者。从1990年1月至2011年9月,所有在我们肾脏中心接受CAPD治疗超过十年的患者都被纳入研究。在超过436例CAPD患者中,11例符合纳入标准。他们的平均PD持续时间为12.3±3.1年。引入CAPD时的平均年龄为46.0±10.1岁。所有患者都有非糖尿病肾病作为其终末期肾病的潜在原因。11例患者中至少有2例发生外溢,1例随后死于外溢。长期CAPD超过十年的患者仍然很少见。如果有效地维持在可接受的水平,CAPD模式可以继续,但EPS仍然是长期PD的严重并发症。
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