ＣＡＰＤ脱落例と継続例の検討

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  • An Investigation of Withdrawals and Continuations in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis(CAPD).

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We retrospectively analyzed the clinical results of 20 patients treated at Saiseikai Maebashi Hospital from 1986 to 1996, with the objective of describing the characteristics of patients for more than 5 years on continuous ambulatory peritoneal dialysis (CAPD).<BR>Among 10 withdrawals, (duration of CAPD less than 5 years; positive selection 5, negative selection 5; diabetic 1, chronic glomerulonephritis 9) 6 were switched over to hemodialysis (HD) and 4 died.<BR>The reasons for transfer to HD were peritonitis in 3, cardiac failure in 1, and others in 2. The causes of death were arrhythmia in 2 cases, peritonitis in one, and sepsis in one. These patients were elderly and had more cardiovascular diseases. The frequency of peritonitis was 1 per 23.8 patient months.<BR>Peritoneal function assessed by the clearance of urea (KT/V) remained normal in 10 continuations. (duration of CAPD more than 5 years; positive selection 9, negative selection 1; chronic glomerulonephritis 10) Mean urea clearance was a KT/V of 1.73. Although the KT/V values were lower than those proposed nowadays, the patients showed good rehabilitation. The frequency of peritonitis was 1 per 52.5 patient months.<BR>The prevention of peritonitis and proper patient selection are important for achieving long term continuation of CAPD.

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