G. Viglino et al., 10 YEARS EXPERIENCE OF CAPD IN DIABETES - COMPARISON OF RESULTS WITH NON-DIABETICS, Nephrology, dialysis, transplantation, 9(10), 1994, pp. 1443-1448
CAPD outcomes were compared between a group of 301 diabetic patients (
mean age +/-SD, 58.9 +/- 12.7 years, 55.8% males) and a group of 1689
non-diabetic patients (mean age +/- SD 57.8 +/- 14.8 years, 55.9% male
s) treated in 30 centres participating in the Italian Cooperative Peri
toneal Dialysis Study Group from 1980 to 1989, with follow-up observat
ion periods of 444 years (mean +/- SD, 1.48 +/- 1.24) and of 3502 year
s (mean +/- SD, 2.07 +/- 1.91) respectively. CAPD was the first modali
ty for 87.2% of diabetics and 78.1% of non-diabetics (P < 0.001). The
percentage of patients who needed a partner for CAPD was 45.9% in diab
etics and 30.2% in non-diabetics (P < 0.001). In diabetics compared wi
th non-diabetics, cardiovascular diseases and cachexia were nearly twi
ce and infections other than peritonitis more than three times as freq
uent in causing death. In diabetics, survival was significantly worse
(P < 0.0001) and the relative risk of death 2.13 times higher (P < 0.0
01). The technique survival and the relative risk of drop-out were not
significantly different in the two groups. Clinical problems were the
most important cause of drop-out among diabetics. The probability and
relative risk of drop-out due to peritonitis, as well as of the first
peritonitis episode, were not significantly different between the two
groups and between diabetics using or not using intraperitoneal insul
in. Days per patient year of hospitalization, excluding the first, wer
e 18.4 in diabetics and 14.3 in non-diabetics. CAPD-related problems c
aused hospitalization in a similar way in the two groups. In conclusio
n, compared to non-diabetics on CAPD, diabetics on the same treatment
showed more clinical problems that account for a higher need of partne
r, death, and hospitalization and are the first reason for technique f
ailure; on the other hand, problems closely related to the CAPD techni
que seem to occur with the same frequency in the two groups.