Comparison of home hemodialysis to continuous ambulatory peritoneal dialysis

Comparison of home hemodialysis to continuous ambulatory peritoneal dialysis. We evaluated prospectively various outcome measurements of patients assigned initially to continuous ambulatory peritoneal dialysis (CAPD) and home hemodialysis (HHD) from February 1979 to August 1981 and the causes for fa...

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Bibliographic Details
Published in:Kidney international 1983-01, Vol.23 (1), p.51-56
Main Authors: Rubin, Jack, Barnes, Tom, Burns, Peggy, Ray, Ricé, Teal, Nancy, Hellems, Eric, Bower, John
Format: Article
Language:English
Subjects:
Adult
Blood Pressure
Cardiovascular Diseases - complications
Female
Hemodialysis, Home - adverse effects
Hospitalization
Humans
Kidney Failure, Chronic - therapy
Male
Middle Aged
Peritoneal Dialysis - adverse effects
Peritoneal Dialysis - mortality
Peritoneal Dialysis, Continuous Ambulatory - adverse effects
Peritoneal Dialysis, Continuous Ambulatory - mortality
Peritonitis - etiology
Prospective Studies
Time Factors
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Summary:Comparison of home hemodialysis to continuous ambulatory peritoneal dialysis. We evaluated prospectively various outcome measurements of patients assigned initially to continuous ambulatory peritoneal dialysis (CAPD) and home hemodialysis (HHD) from February 1979 to August 1981 and the causes for failures of the techniques. Morbidity was assessed by time in hospital/time on dialysis. Fifty-six patients were trained for CAPD and 37 for HHD. Those assigned to CAPD experienced an increased frequency of hospitalization (7.5% CAPD, 2.8% HHD, respectively) primarily due to episodes of peritonitis. There was also a higher modality failure rate (43% vs. 16%). However, the groups were not comparable in all respects. For example, the CAPD population included 21 patients with major cardiovascular diseases versus only three in the HHD group. The demographic characteristics of both populations including race, sex, age, income, place of residence, marital status, and education were similar. At the time of this study there is no direct evidence showing that healthy patients otherwise able to perform HHD may be maintained with less morbidity for a prolonged period utilizing CAPD. Therefore, we suggest that HHD is the home method of choice for patients able to proceed with this technique. CAPD may be indicated for patients in whom the period of home dialysis is expected to be relatively short and who would be otherwise unable to carry out home dialysis, for example, patients awaiting transplantation and those unable to be maintained on hemodialysis because of impaired cardiac function. To fully evaluate CAPD as a long-term maintenance therapy, a prospective trial must be performed. Comparaison de la dialyse à domicile à la dialyse péritonéale continue ambulatoire. Nous avons évalué prospectivement diverses mesures du devenir de malades mis initialement en dialyse péritonéale continue ambulatoire (CAPD) ou en dialyse à domicile (HHD) du 1979 février au 1981 août, et les raisons des échecs de ces techniques. La morbidité a été mesurée par le temp à l'hôpital/temp en dialyse. Cinquante-six malades ont été entraînés pour la CAPD, trente-sept pour l'HHPD. Ceux mis en CAPD ont eu une augmentation accrue de fréquence d'hospitalisation (7,5% CAPD, 2,8% HHD, respectivement) essentiellement due à des épisodes de péritonite. Il y avait également un taux d'échec supérieur (43% contre 16%). Cependant les groupes n'étaient pas comparables sur tous les plans. Par exemple, la population d
ISSN:0085-2538
1523-1755
DOI:10.1038/ki.1983.10