The Survival and Its Associated Factors among Patients with Diabetic Kidney Disease on continuous Ambulatory Peritoneal Dialysis: Three-Year Experience in Maharat Nakhon Ratchasima Hospital
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Abstract
Objective: To evaluate the patient survival and the influencing factors in continuous ambulatory peritoneal dialysis (CAPD) patients with diabetic kidney disease at Maharat Nakhon Ratchasima Hospital. Patients & Methods: Medical records of diabetic CAPD patients in Maharat Nakhon Ratchasima Hospital during January 1, 2008-December 31, 2010 were reviewed. The collected data included demographic details, underlying diseases, body mass index (BMI), laboratory findings, peritonitis episodes, and outcome of therapy on December 31, 2010. Results: One hundred and eleven diabetic CAPD patients were analysed. There were 57.7% male, mean age was 51.9 ± 14.4 year (Range 15.3-78.6 year). The CAPD patients had anemia (67.3%), hypokalemia (36.3%) and hypoalbuminemia (66.3%). In the follow up period, total observation period was 977.4 patient-months. Patient survivals at 1, 2 and 3 years were 64.4%, 47.5% and 47.5%, respectively. The mean patient survival time was 25.6 months. The influencing factors that lowered patient survival were age above 60 years, serum potassium below 3.5 mEq/L and serum albumin <3.5 g/dL. Peritonitis rate was 21.2 patient-months per episode. Streptococcus spp. and Staphylococcus aureus were common causative organisms. Mean patient survival in no-peritonitis group was higher than peritonitis group, without statistic significance. At the end of study, the patients continued on CAPD (60.2%), switched to hemodialysis (4.6%) were referred to another center (0.9%), and died (34.3%). Conclusion: Diabetic CAPD patients had had high incidences of hypokalemia and hypoalbuminemia that influenced the survival of these patients. The peritonitis was not significant influencing factors for patient survival. So there was importance to improve patient survival by correcting the influencing factors and nutritional status in diabetic CAPD patients.
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