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clearance was 62.9 +/- 8.5 L/1.73 m2, and mean serum albumin level was 3.7 +/- 0.6 g/dL. 93 patients (28%) were withdrawn from peritoneal dialysis due to death (12.6%), transplantation (3.9%), transfer to hemodialysis (8.7%), patient failure to adapt (1.5%), and other reasons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.