What really happens to people on long-term peritoneal dialysis?

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What really happens to people on long-term peritoneal dialysis? Simon J. Davies, Louise Phillips, Anne M. Griffiths, Lesley H. Russell, Patrick F. Naish, Gavin I. Russell Kidney International Volume 54, Issue 6, Pages 2207-2217 (January 1998) DOI: 10.1046/j.1523-1755.1998.00180.x Copyright © 1998 International Society of Nephrology Terms and Conditions

Figure 1 Actuarial survival of the whole patient population (N = 303), representing all patients treated with peritoneal dialysis since 1990. The actual numbers of patients alive at each 12month time point are shown. Kidney International 1998 54, 2207-2217DOI: (10.1046/j.1523-1755.1998.00180.x) Copyright © 1998 International Society of Nephrology Terms and Conditions

Figure 2 Actuarial survival of patients according to the treatment modality (Group 1 is PD; Group 2 is transplant; Groups 3 to 5 are on hemodialysis at the time of death or censor (January 1998). Survival in Group 2 was better than for all other groups, P < 0.001 (Log-rank test). Survival for patients remaining on PD was also favorable when compared to all forms of technical failure: Group 3 (multiple peritonitis), P < 0.05; Group 4 (ultrafiltration failure), P = 0.32 and Group 5 (failure to thrive or manage), P < 0.007. Kidney International 1998 54, 2207-2217DOI: (10.1046/j.1523-1755.1998.00180.x) Copyright © 1998 International Society of Nephrology Terms and Conditions

Figure 3 The longitudinal changes in urea clearance are shown for the whole population (solid lines) and for the subgroup of long-term survivors on PD, N = 25, (dashed lines). Data are mean ± se. The initial clearances are significantly greater (*P < 0.02) compared to later measurements, due to the decline in residual renal function. In the medium term residual renal function is relatively well maintained in the long-term patients, (#P < 0.05). Net PD clearances are also shown (diamonds) for the whole population. Kidney International 1998 54, 2207-2217DOI: (10.1046/j.1523-1755.1998.00180.x) Copyright © 1998 International Society of Nephrology Terms and Conditions

Figure 4 Data for the whole population and long-term subgroup are shown as for Figure 3. Data are mean ± se. Weight measurements are shown as square symbols and mid-arm circumference (MAC) as circles. There is a significant rise in weight and MAC during the first year of treatment (*P < 0.02), following which both decline, although this is only significant for MAC (+P < 0.05). Both weight and MAC are relatively well maintained in the long-term group, which is responsible for the late relative improvement in MAC. Kidney International 1998 54, 2207-2217DOI: (10.1046/j.1523-1755.1998.00180.x) Copyright © 1998 International Society of Nephrology Terms and Conditions

Figure 5 Data for the whole population and long-term subgroup are shown as for Figure 3. Solute transport increases with time on PD (*P < 0.05, compared with 6months duration). The long-term subgroup has a significantly lower solute transport in the medium term (#P < 0.05). Kidney International 1998 54, 2207-2217DOI: (10.1046/j.1523-1755.1998.00180.x) Copyright © 1998 International Society of Nephrology Terms and Conditions

Figure 6 Data for the entire population and long-term subgroup are shown as for Figure 3. There is a downward trend in the plasma albumin with time, which reaches significance beyond 42months (*P < 0.05). Plasma albumin is relatively well preserved in the long-term group, as it is significantly higher between 13 and 30months of treatment (#P < 0.05). Kidney International 1998 54, 2207-2217DOI: (10.1046/j.1523-1755.1998.00180.x) Copyright © 1998 International Society of Nephrology Terms and Conditions

Kidney International 1998 54, 2207-2217DOI: (10. 1046/j. 1523-1755 Kidney International 1998 54, 2207-2217DOI: (10.1046/j.1523-1755.1998.00180.x) Copyright © 1998 International Society of Nephrology Terms and Conditions

Kidney International 1998 54, 2207-2217DOI: (10. 1046/j. 1523-1755 Kidney International 1998 54, 2207-2217DOI: (10.1046/j.1523-1755.1998.00180.x) Copyright © 1998 International Society of Nephrology Terms and Conditions

Kidney International 1998 54, 2207-2217DOI: (10. 1046/j. 1523-1755 Kidney International 1998 54, 2207-2217DOI: (10.1046/j.1523-1755.1998.00180.x) Copyright © 1998 International Society of Nephrology Terms and Conditions

Kidney International 1998 54, 2207-2217DOI: (10. 1046/j. 1523-1755 Kidney International 1998 54, 2207-2217DOI: (10.1046/j.1523-1755.1998.00180.x) Copyright © 1998 International Society of Nephrology Terms and Conditions

Kidney International 1998 54, 2207-2217DOI: (10. 1046/j. 1523-1755 Kidney International 1998 54, 2207-2217DOI: (10.1046/j.1523-1755.1998.00180.x) Copyright © 1998 International Society of Nephrology Terms and Conditions

Kidney International 1998 54, 2207-2217DOI: (10. 1046/j. 1523-1755 Kidney International 1998 54, 2207-2217DOI: (10.1046/j.1523-1755.1998.00180.x) Copyright © 1998 International Society of Nephrology Terms and Conditions

Kidney International 1998 54, 2207-2217DOI: (10. 1046/j. 1523-1755 Kidney International 1998 54, 2207-2217DOI: (10.1046/j.1523-1755.1998.00180.x) Copyright © 1998 International Society of Nephrology Terms and Conditions