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.

CONCLUSION

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.