Patient and Technique Survival on Capd in Turkey

Abstract

To analyze the status of continuous ambulatory peritoneal dialysis (CAPD) in 12 centers in Turkey. Retrospective study of CAPD technique and patient outcome. University hospital renal units. 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. Patient survival, technique survival, and duration of hospitalization. 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clearance was 62.9 +/- 8.5 L/1.73 m2, and mean serum albumin level was 3.7 +/- 0.6 g/dL. 93 patients (28%) were withdrawn from peritoneal dialysis due to death (12.6%), transplantation (3.9%), transfer to hemodialysis (8.7%), patient failure to adapt (1.5%), and other reasons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. 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.