Outcome and complications in patients treated with continuous ambulatory peritoneal dialysis (CAPD) at a single centre during 11 years.
OBJECTIVE
To evaluate outcome and complications in patients treated with CAPD at our centre a retrospective study was performed.


METHODS
Relevant data from all 123 consecutive patients on the CAPD program from 1982 to 1994 were reviewed.


RESULTS
Patient survival after 1, 2, 3 years was 89, 78, 69 and 50% respectively. The probability of having a functioning catheter after 1, 2, 3 and 5 years was 90, 77 and 68%, respectively. We observed 179 technical complications (42 intra-abdominal pressure, 137 catheter-related). Peritonitis (220 episodes, 62% gram-positive) occurred with a mean incidence of 1 episode in 13 treatment months and was the main reason (26 cases, 68% gram-positive) for catheter removal. (Mixed) Gram-negative peritonitis was associated with a higher mortality, and relatively more often resulted in termination of CAPD treatment when compared to gram-positive peritonitis. Introduction in 1988 of a new fluid exchange system (Twin Bag) and alcohol disinfection of hands was accompanied by a decreased incidence of peritonitis and exit-site infections, but to date patient, technique and catheter survival have not improved.


CONCLUSIONS
Although therapeutic measures have resulted in a reduced incidence of peritonitis and exit-site infections, infectious and technical complications remain a serious threat to patient and technique survival in CAPD treatment.
Wanten
G J
GJ
Department of Internal Medicine, Bosch Medicentrum, Hertogenbosch, Netherlands.
Koolen
M I
MI
van Liebergen
F J
FJ
Jansen
J L
JL
Wever
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002408:Catheters, Indwelling / Q000009:adverse effects; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality / Q000628:therapy*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000453:epidemiology / Q000209:etiology; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects* / Q000401:mortality; D010538:Peritonitis / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D006435:Renal Dialysis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome