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Continuous cycler therapy, manual peritoneal dialysis therapy, and peritonitis
L K Troidle1, N Gorban-Brennan, A S Kliger
1Renal Research Institute, New Haven, Connecticut, USA.
Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis
|January 29, 2000
Summary
Continuous cycler peritoneal dialysis (CPD) showed lower rates of Staphylococcus aureus, polymicrobial, and fungal peritonitis compared to manual peritoneal dialysis. However, gram-negative peritonitis rates were higher in CPD patients, warranting further investigation.
Area of Science:
- Nephrology
- Internal Medicine
- Medical Technology
Background:
- Standard manual peritoneal-dialysis may not achieve adequate dialysis for all patients.
- Continuous-cycling regimens are increasingly prescribed.
- Controversy exists regarding peritonitis rates between manual and continuous cycler peritoneal dialysis (CPD).
Purpose of the Study:
- To compare the incidence of peritonitis between manual peritoneal dialysis and continuous cycler peritoneal dialysis.
- To investigate differences in specific types of peritonitis (Staphylococcus aureus, polymicrobial, fungal, gram-negative) between the two dialysis methods.
Main Methods:
- Retrospective chart review of CPD patients from June 1994 to December 1996.
- Group I: Manual peritoneal dialysis (Baxter UltraBag).
- Group II: Continuous cycler peritoneal dialysis (Baxter HomeChoice Cycler).
Main Results:
- Overall peritonitis rates were similar between manual (1 episode/10.4 patient-months) and CPD (1 episode/10.0 patient-months).
- CPD showed significantly lower rates of Staphylococcus aureus, polymicrobial, and fungal peritonitis.
- CPD had a higher, though not statistically significant, rate of gram-negative peritonitis.
Conclusions:
- Individual peritonitis rates differ between manual and continuous CPD, despite similar overall rates.
- The potential increase in gram-negative peritonitis with CPD is significant due to its severe outcomes.
- Further randomized, multicenter studies are needed to confirm these findings and compare specific peritonitis types.