Audit of a decade of continuous ambulatory peritoneal dialysis

We have reviewed the results of continuous ambulatory peritoneal dialysis (CAPD) in a single renal unit over the period from December 1979 to the end of 1990. Case records of 211 of the 222 patients treated by CAPD over this period were obtained and age, sex, diagnoses, duration of CAPD, and cause of death determined. We found marked effects of age and a diagnosis of atheromatous vascular disease at the start of CAPD on patient survival. For patients aged under 45 years 5-year patient survival was 78%, for those aged 45-65 it was 29% and for those aged over 65 years it was 32%. Patients with a diagnosis of atheromatous vascular disease at the start of CAPD had a 3-year survival of 25% compared with 69% for age- and sex-matched CAPD patients without such a diagnosis. Five-year technique survival was 67% if failure was defined as transfer to haemodialysis or death as a direct result of CAPD, but only 11% of patients were on CAPD continuously for 5 years. Attempts to compare our results with those from other reports were hindered by the variety of methods used to calculate patient and technique survival; we suggest that standard methods should be agreed.