title: Peritonitis rate: traditional versus low calcium dialysate.
abstract: The results of nonrandomized retrospective studies have suggested that low calcium dialysate (LCD; ionized calcium concentration 1.25 mmol/L) is associated with a higher peritonitis rate than traditional dialysate (TD; ionized calcium concentration 1.75 mmol/L). For this reason, 86 consecutive new continuous ambulatory peritoneal dialysis patients were randomized, in a single-blind fashion, to TD or LCD for 1 year. The results were analyzed on an intention-to-treat basis, no matter what fluid or what modality of treatment was being used at the end of the year. The two groups were well matched at baseline. At 1 year, 28 of 43 TD patients were still on continuous ambulatory peritoneal dialysis (one had a catheter changed due to peritonitis), four had a working transplant, one had recovered renal function, nine had died, and one had been transferred to hemodialysis because of peritonitis. Twenty-seven of 43 LCD patients were on continuous ambulatory peritoneal dialysis (one catheter change), nine had a working transplant, six had died, and one was on hemodialysis. There were 17 proven (33 possible) peritonitis episodes in 417 patient-months in the TD group. In the LCD group, there were 17 (35 possible) episodes in 432 patient-months. The proven peritonitis rate was 0.49 episodes/patient/yr in the TD group versus 0.48 episodes/patient/yr in the LCD group (P = NS). In conclusion, there is no controlled evidence that LCD is associated with a higher incidence of peritonitis than TD.
authors.affiliation: Department of Nephrology, Leicester General Hospital, United Kingdom.
authors.forename: A
authors.initials: A
authors.lastname: Stein
authors.forename: F
authors.initials: F
authors.lastname: Baker
authors.forename: J
authors.initials: J
authors.lastname: Moorhouse
authors.forename: J
authors.initials: J
authors.lastname: Walls
mesh_terms: D002118:Calcium / Q000032:analysis*; D015314:Dialysis Solutions / Q000737:chemistry*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010538:Peritonitis / Q000209:etiology*; D016037:Single-Blind Method
chemical_list: D015314:Dialysis Solutions; D002118:Calcium