Significant reduction of peritonitis rate by the use of Twin-bag system in a Canadian regional CAPD program

In a regional CAPD program in Northern Alberta, Canada, the peritonitis rates among patients undergoing CAPD treatment were quite high: 1/8.3 and 1/7.4 per patient month from a population of 75 and 76 patients in 1989 and 1990 respectively. Our patient population is comprised of different ethnic groups, separated widely from the dialysis centre; over half of them are above the age of 60 years. As it is not possible to change the patient characteristics in our centre, we switched to the Twin-bag disconnect system in 83 out of a total of 103 patients in 1991. With this change our overall peritonitis rate has significantly improved to 1/14 per patient months and 1/17 per patient months in patients using the Twin-bag system. This improvement in the peritonitis rate has occurred without any change in our patient characteristics. We find the improvement in our peritonitis rate is due to the use of the new Twin-bag system, which provides total disconnection with no spikes and thereby reduces peritonitis due to touch contamination.