HEMODIALYSIS OR CONTINUOUS AMBULATORY PER ITONEAL-DIALYSIS (CAPD) IN DIABETICS WITH RENAL-INSUFFICIENCY

A comparative study on the historic clinical and chemical parameters o f 68 diabetics on peritoneal dialysis (38 men, 30 women; thereof 44 ty pe I; 24 type II diabetics) and 45 diabetics on hemodialysis (27 men; 18 women; thereof 22 type I; 23 type II diabetics) was performed. A li fe expect-ancy curve, the average survival expectancy and a cumulative sur-vival rare for 2 and 4 years was determined for both groups of pa -tients, respectively In this respect, the patients were additionally divided into two subgroups, depending on the clinical diagnosis upon o nset of dialysis treatment: patients with two or fewer (group I) and p atients with three or more additional organical complica-tions (group II). The results show in accordance with literature that the effectivi ty and the rate of complications of both treatment methods during the first four years do not differ significantly. CAPD offers methodical a dvantages, since it involves a simple home dialysis treatment, the glu cose level is easier to control and the needed dosis of antihypertensi ve medication and erythropoetin is lower. When comparing the total num ber of CAPD and hemodialysis patients, no significant difference can b e determined with respect to the life expentancy curve, the cumulative survival rate and the average survival expentancy. Also, between the patients of group I and group II the difference between hemo- and peri toneal dialysis patients was not significant with respect to these par a-meters. A significant difference (p > 0.001) is found, however, not only with the hemo- but also with the peritoneal dialysis patients amo ng group I and II: The four year survival race came to 43.4% resp. 80% for group I; 11.1% resp. 12.0% for group II. The average life expecta ncy for peritoneal dialysis patients in group I was 54.8 months, for h emodialysis patients 41.3 months. The re-spective numbers for patients classified in group II were 15.7 and 22.3 months. The prognosis for g roup II patients must be classified as unfavourable according to these findings. Hemo-dialysis is therefore quoad vitam no second class trea tment for diabetics with renal insufficiency but an alternative method which should be used primarily, when the use of CAPD, for example bec ause of absence of presumption for home dialysis, is not possible.