Continuous ambulatory peritoneal dialysis: an option in the developing world?
OBJECTIVE
To evaluate specified biomedical, socio-economic, and psychosocial criteria as predictors of therapeutic success to optimize patient selection for continuous ambulatory peritoneal dialysis (CAPD) in a developing country.


METHODS
A retrospective cohort study investigating the relationship between episodes of peritonitis and exitsite infection, and predetermined biomedical, socioeconomic, and psychosocial data.


METHODS
A CAPD unit in a large tertiary care teaching hospital.


METHODS
All 132 patients entering the CAPD program between 1987 and 1991.


RESULTS
Overall mean survival time on CAPD was 17.3 months. Peritonitis rates were high, especially among blacks. Multivariate analysis demonstrated that increased peritonitis rates were associated with age, black race, diabetes, and strongly so with several psychosocial factors. Because being black was strongly linked to poor socioeconomic conditions, repeat analysis excluding blacks showed the same associations with the above variables, but, additionally, several socioeconomic factors were associated with high peritonitis rates. No significant explanatory variables were shown for exit-site infections.


CONCLUSIONS
The association of biomedical, socioeconomic, and psychosocial variables with high peritonitis rates has important implications for the selection of patients for CAPD in this setting.
Zent
R
R
Department of Medicine, Groote Schuur Hospital, Cape Town, South Africa.
Myers
J E
JE
Donald
D
D
Rayner
B L
BL
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D044383:Black People; D015331:Cohort Studies; D003859:Dependent Personality Disorder / Q000453:epidemiology; D003906:Developing Countries / Q000706:statistics & numerical data*; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D015276:Health Care Rationing / Q000706:statistics & numerical data; D006798:Housing / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects / Q000706:statistics & numerical data*; D010538:Peritonitis / Q000453:epidemiology; D006435:Renal Dialysis / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data