Document Detail

Continuous ambulatory peritoneal dialysis: three years' experience.
MedLine Citation:
PMID:  6611839     Owner:  NLM     Status:  MEDLINE    
We review the experience of the Renal Unit at Newcastle upon Tyne over the three years 1979-1981, during which 122 patients with chronic renal failure were treated by continuous ambulatory peritoneal dialysis (CAPD). Advantages of the technique included wide acceptability to a cross-section of patients reaching the renal unit, including the elderly and diabetics. Patients who experienced both techniques preferred CAPD to haemodialysis because of the greater freedom and sense of well-being. Patient survival was 94 per cent at two years and rehabilitation was as good as could be expected for the age and primary medical complications of the patients. Control of plasma potassium and phosphate was easier than with haemodialysis. Renal osteodystrophy responded well to a combination of CAPD and alfacalcidol therapy over the two year period for which we have performed serial bone biopsies. Serum aluminium was slightly raised as a result of consumption of phosphate binders and presumed uptake from dialysis fluid but no aluminium related disease has yet been encountered. Anaemia was partly corrected by CAPD with haemoglobin rising to about 10 g/dl on average. CAPD was less costly than home haemodialysis over the first three years and has been adopted as our standard treatment for patients who can expect an early transplant. Disadvantages were persisting problems with peritonitis which still occurred at an incidence of one attack per 39 patient weeks over the last two years, and an actuarial success rate for the technique of only 63 per cent at two years. Twenty patients developed hernias. Weight gain was common and occasionally gross. There was a significant rise in serum cholesterol. The arrival of CAPD has allowed us to increase the intake to our renal failure programme by 50 per cent. However, continued expansion of the technique demands advances in prevention of peritonitis, adequate facilities for admission and particularly an expanding hospital haemodialysis programme to accept the less successful patients from CAPD.
J M Ramos; R Gokal; K Siamopolous; M K Ward; R Wilkinson; D N Kerr
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Quarterly journal of medicine     Volume:  52     ISSN:  0033-5622     ISO Abbreviation:  Q. J. Med.     Publication Date:  1983  
Date Detail:
Created Date:  1983-10-21     Completed Date:  1983-10-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0401027     Medline TA:  Q J Med     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  165-86     Citation Subset:  IM    
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MeSH Terms
Aluminum / blood
Blood Pressure
Bone and Bones / pathology
Calcifediol / blood
Child, Preschool
Costs and Cost Analysis
Kidney Failure, Chronic / metabolism,  mortality,  therapy
Middle Aged
Parathyroid Hormone / blood
Peritoneal Dialysis* / adverse effects
Peritoneal Dialysis, Continuous Ambulatory* / adverse effects,  economics
Peritonitis / etiology
Reg. No./Substance:
0/Parathyroid Hormone; 19356-17-3/Calcifediol; 7429-90-5/Aluminum

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