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. OBJECTIVES 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 endstage renal disease.
Introduction: in Cuba the peritoneal dialysis was introduced at the end of the 60s; the peritonitis the was the more fearsome complication. Objective: to determine the incidence rate of peritonitis in a program of peritoneal dialysis at home. Methods: a prospective, descriptive and observational study was conducted in a universe including 30 patients from December, 2007 to May, 2011. Authors analyzed the demographic variables and the peritonitis presence. The distribution of frequency analysis was used as well as the Kaplan Meier for the time of the peritonitis-free survival. Results: from the total of patients, 17 had one episode of peritonitis, 6 had a second episode whereas only one had a third event for a total of 24 episodes of peritonitis; similar to an episode each 32 months/patient, these events occurred in 12 male patients and in 5 female patients; mean age was of 46,2 years. Conclusions: although the incidence of peritonitis became decreasing in past years, it remains as the leading complication of this therapeutical procedure.
Introducción: en Cuba se introdujo la diálisis peritoneal a finales de los años 60, la peritonitis es la complicación más temida. Objetivo: determinar la frecuencia y la tasa de peritonitis en un programa de diálisis peritoneal domiciliaria. Métodos: se realizó un estudio observacional, descriptivo y prospectivo desde diciembre de 2007 hasta mayo de 2011. El universo estuvo constituido por 30 pacientes. Se analizaron las variables demográficas y la presencia de peritonitis. Se utilizó el análisis de distribución de frecuencias, además el Kaplan Meier para el tiempo de supervivencia libre de peritonitis. Resultados: del total de pacientes, 17 presentaron 1 episodio de peritonitis, 6 tuvieron un segundo episodio, mientras solo 1, sufrió un tercer evento para un total de 24 episodios de peritonitis; equivalente a un episodio cada 32 meses/paciente, estos se presentaron en 12 enfermos masculinos y 5 femeninos; la edad promedio fue de 46,2 años. Conclusiones: aunque la incidencia de peritonitis ha venido descendiendo en los últimos años, continúa siendo la principal complicación de este proceder terapéutico.