Continuous ambulatory peritoneal dialysis in insulin-dependent diabetic patients: A 40-month experience

Diabetic nephropathy is becoming a major and growing cause of endstage renal disease (ESRD) in all industrialized countries [1, 2]. In Europe, the number of patients with diabetic nephropathy and ESRD that have been put on renal replacement therapy has increased rapidly during the last years. By the end of 1980, diabetic patients accounted for 3% of all patients alive and treated by a dialysis method or living with a functioning graft [1]. As demonstrated by recent results [1, 3, 4–6] exclusion of insulin-dependent diabetic (IDD) patients from renal function replacement therapy is no longer acceptable when treatment facilities are available; therefore, time has come for a critical appraisal of the results obtained with different dialysis techniques in a diabetic population.Continuous ambulatory peritoneal dialysis (CAPD), a valuable alternative to hemodialysis in treating ESRD [7–12] is currently quoted as a satisfactory dialysis method for IDD patients [5, 6, 13–17]. Recently very encouraging results observed in 20 patients have been reported by Amair et al [18]. However, small series and too brief follow-up periods have not allowed valid comparisons between CAPD and other modes of therapy in a diabetic population. In this study, we report our experience with 24 IDD patients treated by CAPD over a 40-month period