Continuous ambulatory peritoneal dialysis and survival of HIV infected patients with end-stage renal disease

Kimmel, Paul L.; Umana, Walter O.; Simmens, Samuel J.; Watson, Joan; Bosch, Juan P.
August 1993
Kidney International;Aug1993, Vol. 44 Issue 2, p373
Academic Journal
As the number of human immunodeficiency virus (HIV) infected patients has increased in the U.S., the number of infected patients treated for end-stage renal disease (ESRD) has stabilized at about 1 to 2% of the hemodialyzed population. Little has been written regarding the role of continuous ambulatory peritoneal dialysis (CAPD) in the treatment of HIV infected patients with ESRD. To evaluate the effectiveness of CAPD as a Ions term therapy for HIV infected patients with ESRD, we reviewed our ESRD program's experience. We entered 392 patients from its inception in February 1984 until April 1992. Thirty-one, or 7.9% of our population were HIV infected. Twenty, or 64.5% had stage IV infection. Patients were .entered into our chronic hemodialysis (HD)or CAPD program according to standard clinical criteria. Eight HIV infected patients elected to start CAPD, while 23 patients were treated exclusively with HD. The proportion of stage IV infected patients was similar in both treatment modality groups. HIV infected ESRD patients were younger than non-HIV infected patients (37.5 ± 9.7 vs. 49.8 ± 15.7 years, respectively, P < 0.0001) at the start of treatment. We used Cox regression techniques to analyze survival data. Mean survival time for our entire non-HIV infected ESRD population (N = 361) was 44.0 ± 33.9 months. Mean survival time for HIV infected patients with ESRD was 15.5 ± 9.9 months. Median survival for HIV infected ESRD patients was 13 months compared to 38 months for the non-infected population. As expected, mean survival time in HIV infected ESRD patients was significantly diminished compared to non-infected ESRD patients (P < 0.0001). When HIV infected patients were analyzed separately, however, there was no difference in mean survival time between patients treated with HD and CAPD (14.7 ± 9.7 vs. 17.9 ± 10.7 months, respectively). Age, HIV status and stage of HIV infection were predictors of survival in ESRD patients, while sex and race were not. The peritonitis rate in HIV infected patients treated with CAPD was not different from that in non-HIV infected CAPD patients. The etiologic agents of peritonitis in the HIV-infected population were similar to those in non-infected populations. We conclude that HD and CAPD are equally good treatment alternatives for HIV infected patients with ESRD.


Related Articles

  • Muscle biopsy studies in chronically uremic patients: Evidence for malnutrition. Guarnieri, Gianfranco; Toigo, Gabriele; Situlin, Roberta; Faccini, Luigi; Coli, Ugo; Landini, Silvano; Bazzato, Giorgio; Dardi, Franco; Campanacci, Luciano // Kidney International Supplement;Dec1983, Issue 16, pS187 

    The article reports on the results of a study of muscle metabolism in chronically uremic patients receiving conservative treatment, maintenance hemodialysis or continuous ambulatory peritoneal dialysis (CAPD). A description of the experimental setup and measurement methods is given. The study...

  • Apolipoprotein B-containing lipoproteins in renal failure: The relation to mode of dialysis. Attman, Per-Ola A.; Samuelsson, Ola G.; Moberly, James; Johansson, Ann-Cathrine; Ljungman, Susanne; Weiss, Lars G.; Knight-Gibson, Carolyn; Alaupovic, Petar // Kidney International;Apr1999, Vol. 55 Issue 4, p1536 

    Apolipoprotein B-containing lipoproteins in renal failure: The relation to mode of dialysis. Background. The aim of this study was to establish whether there is a differential effect of mode of dialysis, hemodialysis (HD), or continuous ambulatory peritoneal dialysis (CAPD) on the dyslipidemia...

  • Nutritional and metabolic studies in children on continuous ambulatory peritoneal dialysis. Broyer, Michel; Niaudet, Patrick; Champion, Gérard; Jean, Geneviève; Chopin, Nicole; Czernichow, Paul // Kidney International Supplement;Nov1983, Issue 15, pS-106 

    A study was done of 15 children and adolescents, aged 2.5 to 17.5 years, who were treated by continuous ambulatory peritoneal dialysis (CAPD) for 6 to 24 months Plasma albumin concentration decreased from 34.4 ± 4.8 g/liter at the onset of therapy to 31.3 ± 5.3 g/liter after 19 to 24...

  • An overview of chronic kidney disease management and CAPD in the home. Jain, Neerja; Simoyi, Pat // British Journal of Community Nursing;May2008, Vol. 13 Issue 5, p213 

    Chronic kidney disease (CKD) is a common, harmful, but treatable long term condition. An overview of CKD is provided in this article. Kidney Research UK, www.kidneyresearchuk.org a national charity dedicated to research, has developed the A Better Life through Education and empowerment (ABLE)...

  • Patent processus vaginalis in peritoneal dialysis. Millán, Isabel; Sirvent, Ana E; Francisco Ramón, José; Díez, María // Kidney International;Sep2013, Vol. 84 Issue 3, p628 

    The article presents case studies of a 78-year-old man with end-stage renal disease (ESRD) and a 66-year-old man with ESRD. The 78-year-old man has developed severe scrotal and penile edema when he resumed continuous ambulatory peritoneal dialysis (CAPD) after surgery. The 66-year-old man has...

  • Influence of continuous ambulatory peritoneal dialysis on the anemia of endstage renal disease. de Paepe, Marc B. J.; Schelstraete, Karel H. G.; Ringoir, Severin M. G.; Lameire, Norbert H. // Kidney International;May1983, Vol. 23 Issue 5, p744 

    To evaluate the effect of continuous ambulatory peritoneal dialysis (CAPD) on the anemia of endstage renal disease, serial measurements of red cell mass and other hematological parameters were performed in 34 patients. Twenty-five patients were measured at the start and at 6 months (group 1), 13...

  • Accumulation of carboxy-terminal fragments of parathyroid hormone-related protein in renal failure. Orloff, John J.; Soifer, Neil E.; Fodero, Joseph P.; Dann, Pamela; Burtis, William J. // Kidney International;Jun1993, Vol. 43 Issue 6, p1371 

    We have recently demonstrated elevations of separate amino- and carboxy-terminal parathyroid hormone-related protein (PTHdP) fragments in patients with humoral hypercalcemia of malignancy (HHM) using both a two-site immunoradiometric assay (IRMA) with amino-terminal specificity for PTHrP, and...

  • New frontiers in continuous ambulatory peritoneal dialysis. Medcalf, James F.; Walls, John // Kidney International Supplement;Nov1997, Issue 62, pS-108 

    The article talks about the developments in continuous ambulatory peritoneal dialysis (CAPD). CAPD has been a treatment for end-stage renal failure for twenty years. During this span of time, there have been progresses made both in dialysis techniques and the comprehension of its benefits and...

  • Acid-base balance in chronic peritoneal dialysis patients. Uribarri, Jaime; Buouing, Joey; Oh, Man S. // Kidney International;Jan1995, Vol. 47 Issue 1, p269 

    Endogenous acid production has never been measured directly in dialysis patients and an empiric formula is used to estimate acid production from their protein catabolic rate. We have studied acid-base balance in 19 stable CAPD patients attending the peritoneal dialysis clinic of Mount Sinai...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics