ABSTRACT
INTRODUCTION: Peritoneal dialysis is a maintenance therapy option for patients with end-stage renal disease. Continuous ambulatory peritoneal dialysis in Cuba was introduced in December 2007, and automated peritoneal dialysis one year later. This paper presents the outcomes attained with this blood purification technique, enabling an assessment to decide on scaling up its use in Cuba. OBJECTIVE: Describe the clinical course of patients in the first five years of the Home Peritoneal Dialysis Program at Havana's Nephrology Institute. METHODS: An observational, descriptive study with a retrospective cohort was conducted. The universe comprised the 40 Nephrology Institute patients who underwent treatment with home peritoneal dialysis from December 20, 2007 to December 20, 2012. Relative and absolute frequencies were calculated for the study variables and the Kaplan-Meier method was used for survival curves for patients and for the peritoneum as dialysis membrane. RESULTS Of the 40 patients in the program, 23 were men and 17 were women, primarily aged 40 to 59 years. The most frequent causes of chronic kidney failure were hypertension (42.5%), glomerulopathies (22.5%), and diabetes mellitus (22.5%). A total of 103 complications occurred, both infectious (68, 66%) and non-infectious (35, 34%). The most common infectious complication was peritonitis (45, 66.2%); the most frequent non-infectious complication was catheter displacement (13, 37.1%). Seven patients left the peritoneal dialysis program. Of these, three died, two lost function of the peritoneum as a dialysis membrane, one received a kidney transplant and one recovered kidney function. Survival was 100% at one year, 97% at 2 years, 93.2% at 3 and 4 years, and 92% at 5 years. However, the peritoneal membrane was functional in 100% of patients during the first 2 years, decreasing to 96% at 3 and 4 years and to 88.6% at 5 years. CONCLUSIONS: In our setting, peritoneal dialysis attained outcomes similar to those obtained internationally, which supports its usefulness as a renal replacement therapy method in Cuban patients with end-stage renal disease.
Subject(s)
Kidney Failure, Chronic/therapy , Outcome Assessment, Health Care/statistics & numerical data , Peritoneal Dialysis, Continuous Ambulatory/methods , Adult , Cuba , Female , Hemodialysis, Home/adverse effects , Hemodialysis, Home/instrumentation , Hemodialysis, Home/methods , Humans , Kaplan-Meier Estimate , Kidney Failure, Chronic/mortality , Male , Middle Aged , Mortality/trends , Peritoneal Dialysis, Continuous Ambulatory/adverse effects , Peritoneal Dialysis, Continuous Ambulatory/instrumentation , Retrospective Studies , Time FactorsABSTRACT
La diabetes mellitus constituye un problema importante de salud en el mundo actual. Es una de las diez primeras causas de muerte en muchos paises y la séptima en Cuba hasta 1986. La nefropatía es una de las principales complicaciones, es la segunda causa de muerte entre todos los diabéticos y la primera entre aquellos en que la enfermedad comienza en las tres primeras décadas de la vida. Estos pacientes no sólo padecen las dolencias genitourinarias que afectan a los no diabéticos, sino que sufren además las alteraciones funcionales y estructurales que la diabetes es capaz de producir y que en buena parte de ellos provocan insuficiencia renal crónica. Son estas lesiones las que se identifican como nefropatía diabética, y cuyo desarrollo en los aspectos clínico e investigativo pueden ser dividido en cinco etapas
Subject(s)
Humans , Diabetic NephropathiesABSTRACT
La diabetes mellitus constituye un problema importante de salud en el mundo actual. Es una de las diez primeras causas de muerte en muchos paises y la séptima en Cuba hasta 1986. La nefropatía es una de las principales complicaciones, es la segunda causa de muerte entre todos los diabéticos y la primera entre aquellos en que la enfermedad comienza en las tres primeras décadas de la vida. Estos pacientes no sólo padecen las dolencias genitourinarias que afectan a los no diabéticos, sino que sufren además las alteraciones funcionales y estructurales que la diabetes es capaz de producir y que en buena parte de ellos provocan insuficiencia renal crónica. Son estas lesiones las que se identifican como nefropatía diabética, y cuyo desarrollo en los aspectos clínico e investigativo pueden ser dividido en cinco etapas
