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Perit Dial Int 28(5): 518-526
2008
© 2008 International Society for Peritoneal Dialysis
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Clinical

IN-CENTER INTERMITTENT PERITONEAL DIALYSIS: RETROSPECTIVE TEN-YEAR SINGLE-CENTER EXPERIENCE WITH THIRTY CONSECUTIVE PATIENTS

Alexander Woywodta , Matthias Meiera, Doris Kaiser, Gabriele Schneider, Hermann Haller and Marcus Hiss

Division of Nephrology, Department of Medicine, Hannover Medical School, Hannover, Germany

Footnotes

a These authors contributed equally to this work.

Correspondence to: A. Woywodt, Renal Unit, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Sharoe Green Lane, Preston PR2 9HT United Kingdom. Alex.Woywodt{at}lthtr.nhs.uk

{diamondsuit} Background: In-center intermittent peritoneal dialysis (IPD) is sometimes performed in elderly and multimorbid patients that have failed hemodialysis and that are unable to perform peritoneal dialysis (PD) at home. Complications, frequency of hospital admission, and survival are often claimed to be dismal although current data are lacking.

{diamondsuit} Methods: We performed a retrospective cohort study of patients that underwent IPD at Hannover Medical School, Germany, between 1997 and 2007. Underlying renal disorders, comorbidity, and circumstances that precluded hemodialysis and home PD were recorded. Survival, cause of death, episodes of hospitalization, and episodes of peritonitis were calculated. Laboratory values at baseline and after 3 months of IPD were also retrieved.

{diamondsuit} Results: We identified 30 patients with severe comorbidity (median Charlson Comorbidity Index of 6; n = 30) who underwent IPD for 439 months in total. The majority of patients had vascular/hypertensive nephropathy (n = 12; 40%); congestive heart failure was the leading cause for choosing PD (n = 13; 43.3%); 73.3% of our patients had either no partner or at least one disease that precluded home therapy. Hospitalization rate was 1.39 admissions per patient-year and there was 1 episode of peritonitis per 48.8 IPD-months. Mean survival was 26.6 months (median 17 months; n = 30); sepsis was the leading cause of death (n = 13; 59.1%).

{diamondsuit} Conclusions: IPD is associated with fewer episodes of peritonitis, fewer admissions, and longer survival than is often believed. Suitable patients in whom palliative care alone seems inappropriate should not be denied a trial of IPD if they so choose.

KEY WORDS: In-center peritoneal dialysis; elderly; comorbidity; hospitalization; outcome.

Received 18 August 2007; accepted 31 March 2008.






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