Diálise peritoneal: experiência de dez anos em um centro de referência no Brasil

Abstract

INTRODUCTION: Peritoneal dialysis (PD) is underutilized in most countries, usually not offered as initial therapeutic option, negative selection is common. OBJECTIVE: To characterize the PD program of a reference dialysis centre in the Northeast. METHODS: Retrospective cohort study that evaluated clinical and sociodemographic profile, history of treatment and causes of death of 565 patients who remained in PD for at least 30 days from 01/01/2003 to 12/31/2012. RESULTS: Patients had an average age of 54 ± 19 years old, were men (55%), living outside Sergipe’s capital (63%), 76% studied <4years and 88% had family income <5 minimum salaries. Diabetic nephropathy was the main cause (46%) and 76% were hypertensive. There were 91% of late referencing. PD was the initial dialysis modality for 53% of patients, mainly as emergency (58%). They remained in PD by an average of 710.5 (± 714.2) days; 61% also underwent hemodialysis. 676 peritoneal catheters were implanted, mainly by a nephrologist (81%) and were withdrawn particularly by infections (21%). Prevailed peritonitis by S. aureus (25%), the global index was one episode every 27 months. Survival of patients (59% in two years) and technique (77% in two years) was higher in non-diabetic and deaths occurred mainly from cardiovascular causes (50%). CONCLUSIONS: Negative selection for DP is not an atribute of the service studied, dominated by individuals with low socioeconomic status and without access to conservative treatment. Hemodialysis and DP proved as complementary techniques and survival, peritonitis rates and complications were similar to that described in the literature.