Korean Journal of Nephrology 1986;5(1):69-77.

당뇨병성 만성신부전증의 CAPD 치료성적

오상권 , 황승덕 , 이희발

Abstract

Between 1981 and 1985, 19 diabetic patients with end-stage renal disease aged 34 to 75 years(mean age 52. 3) were treated with continous ambulatory peritoneal dialysis(CAPD) for periods of 6 days to 24 months(average 7. 8 months). Eight patients were treated for 12 months or more. Mean dura- tion of diabetes before CAPD was 1 2. 7 years. Extrare nal complications were frequent at the start of CAPD: hypertension in all lg patients, retinopathy in 16, symptomatic peripheral neuro- pathy in 6, cataract and pericardial effusion in 4 each, ischemic heart disease in 3 and cerebrova- scular disease in 2. All patients had at least 2 complications and 12 patients had 4 or more com- plications simultaneously. The actuarial patient survival rate was 73. 5 %and the technique survival rate 68. 2% at one year. The patient and technique survival rate for non- diabetic patients during the same peiod were 90. 2 and 72. 3o respectively. The patient survival rate was significantly lower in diabetic than in non-diabetic patients(p(0. 001) The technique survival rate was not different nor was the in- cidence of peritonitis and catheter exit-site infec- tion between the 2 groups. Fasting blood sugar control was satisfactory with intraperitoneal infusion of regular insulin. Blood pressure control was also satisfactory: an- tihypertensive drugs were discontinued or the dose reduced in 13 of 19 patients. The hematocrit and serum albumin were higher one year after CAPD although not statistically significant. Visual acuity remained poor and unchanged in 5 patients during the mean follow-up period of 7. 5 months. In conclusion, CAPD with intraperitoneal adm- inistration of insulin may be a good alternative treatment for diabetic patients with end-stage renal disease.