title: Comparisons of Y-set disconnect system (Ultraset) versus conventional spike system in uremic patients on CAPD: outcome and cost analysis.
abstract: We conducted a single-blind, prospective randomized study on the use of the Y-set disconnect system (Ultraset) (U) versus the conventional (C) spike system to assess the peritonitis rate, exit-site infection (ESI), clinical outcome, the resulting hospitalization rate, and recurrent costs. Forty new end-stage renal failure patients admitted to the dialysis program were recruited into the study and 20 each were randomly allocated to the U and C systems. They were studied for a period of 12 months. The mean number of days required to train patients for the U and C systems were 8.6 and 9.8 days, respectively. The peritonitis rates for the U and C systems were one episode every 17 and 11.4 patient-months, respectively. The ESI rates for the U and C systems were one episode every 26.4 and 21.6 patient-months, respectively. Four catheters were removed due to fungal peritonitis (three with the C system and one with the U system). As related to peritonitis, patients on the C system required 57 hospital-days while those on the U system required 28 days per year. On cost analysis, the extra cost required for the U system can be offset by the other expenses incurred for events related to more infections on the C system. It is concluded that for the similar cumulative costs required for the patients on the two systems, the Y-set disconnect has a better morbidity profile than the conventional spike system.
authors.affiliation: Department of Medicine, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong.
authors.forename: P K
authors.initials: PK
authors.lastname: Li
authors.forename: T H
authors.initials: TH
authors.lastname: Chan
authors.forename: W Y
authors.initials: WY
authors.lastname: So
authors.forename: A Y
authors.initials: AY
authors.lastname: Wang
authors.forename: C B
authors.initials: CB
authors.lastname: Leung
authors.forename: K N
authors.initials: KN
authors.lastname: Lai
mesh_terms: D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000191:economics / Q000209:etiology; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D006723:Hong Kong; D006801:Humans; D007676:Kidney Failure, Chronic / Q000191:economics / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000191:economics / Q000295:instrumentation*; D010538:Peritonitis / Q000191:economics / Q000209:etiology; D011446:Prospective Studies; D016037:Single-Blind Method; D016896:Treatment Outcome