Hans Jakob Gloor1. 1. Medizinische Abteilung, Kantonsspital Schaffhausen. hansjakob.gloor@kssh.ch
Abstract
PRINCIPLES: Few long term studies exist about peritoneal dialysis (PD). We collected the experiences over nearly 20 years in a single mid-sized centre in Switzerland. METHODS: In a retrospective survey we examined our PD-cohort with respect to mortality, technique survival, peritonitis rate and other complications. We calculated the proportion of PD-patients of the total dialysis population (penetration rate) and measured the time of PD-associated hospitalisations. RESULTS: 50 patients were included during an observation period of 20 years. The mean penetration rate was 23% (range 11% to 34%). The mean treatment time per patient was 2.8 years (median: 3.6 years; range 0.4-9.5 years). Patient survival was 80% at three years and 60% at five years. Technique retention rate was 40% after three, and 20% after five years. Each of the three outcome categories--transplantation, switch to haemodialysis (HD) and death during PD--accounted for one third of the PD drop-out number. CONCLUSION: Compared to the average of Swiss dialysis centres the penetration rate is high. Patient and technique survival correspond to data in the literature, as do the frequency and types of complications. We consider PD as an efficient and well tolerated dialysis modality, which should be offered also in smaller dialysis centres. Since PD is not only feasible, but appears to be less costly than HD, we recommend PD as the first-line dialysis option for patients in end-stage renal disease.
PRINCIPLES: Few long term studies exist about peritoneal dialysis (PD). We collected the experiences over nearly 20 years in a single mid-sized centre in Switzerland. METHODS: In a retrospective survey we examined our PD-cohort with respect to mortality, technique survival, peritonitis rate and other complications. We calculated the proportion of PD-patients of the total dialysis population (penetration rate) and measured the time of PD-associated hospitalisations. RESULTS: 50 patients were included during an observation period of 20 years. The mean penetration rate was 23% (range 11% to 34%). The mean treatment time per patient was 2.8 years (median: 3.6 years; range 0.4-9.5 years). Patient survival was 80% at three years and 60% at five years. Technique retention rate was 40% after three, and 20% after five years. Each of the three outcome categories--transplantation, switch to haemodialysis (HD) and death during PD--accounted for one third of the PD drop-out number. CONCLUSION: Compared to the average of Swiss dialysis centres the penetration rate is high. Patient and technique survival correspond to data in the literature, as do the frequency and types of complications. We consider PD as an efficient and well tolerated dialysis modality, which should be offered also in smaller dialysis centres. Since PD is not only feasible, but appears to be less costly than HD, we recommend PD as the first-line dialysis option for patients in end-stage renal disease.