MORTALITY-RATE, CHANGE OF METHOD AND HOSP ITALIZATION IN CAPD COMPARED WITH HEMODIALYSIS

Background and objective of study: Continuous ambulatory peritoneal di alysis (CAPD) still plays a minor role in Germany compared with haemod ialysis (HD) in the management of terminal renal failure. An investiga tion was undertaken to compare mortality rate, change of dialysing met hod as well as number and duration of hospital stays of patient underg oing CAPD or HD at a nephrological centre. Patients and methods: All 1 66 patients in terminal renal failure (except those with a malignancy) admitted between January 1987 and December 1992 were included (63 wom en and 103 men, aged 19-84 years). The choice between the two dialysis methods was made by the patients after detailed information had been given. Taking into account basic disease and any secondary illness as well as age and sex, survival time, any change of dialysing method and hospitalisation details were prospectively analysed for the two dialy sing methods. Results: After 4 years there were no significant differe nces in mortality Fate between the two methods (HD 37%, CAPD 29%). The Cox model revealed no influence of various parameters on the mortalit y rate of the two methods. However, cumulative patients survival was s ignificantly decreased by arteriosclerotic disease (P < 0.05; probabil ity of survival after 4 years was 53% and 73%, respectively for HD and 57% and 77% for CAPD). Similarly, age greater than or equal to 60 yea rs at onset of dialysis significantly lowered probability of survival (after 4 years of dialysis, 53% vs 70% for HD, 45% vs 80% for CAPD: P < 0.05). But there were no significant differences between the two met hods with respect to these two factors. After 4 years, ''method surviv al'' was more common with HD (94%) than CAPD (64%), P < 0.05). In part icular diabetics had a significantly lower ''method survival'' after 4 years than non-diabetics (29% vs 74%). There was no significant diffe rence between the two methods regarding number and duration of hospita l stays. Conclusions: These data show that, in a nephrological centre with long experience in both methods of dialysis, CAPD is an equal alt ernative to HD.