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Continuous ambulatory peritoneal dialysis (CRPD)--an initial Indian experience
N P Singh1, S Gupta, J Chandra
1Department of Medicine, MAMC & Associated LN Hospital, New Dehli 110002.
Journal of the Indian Medical Association
|July 13, 2005
Summary
Continuous ambulatory peritoneal dialysis (CAPD) offers a viable renal replacement therapy in India, showing significant lab improvements but also lipid changes and peritonitis risks. The Y-set demonstrated a lower peritonitis rate compared to the standard set.
Area of Science:
- Nephrology
- Renal Replacement Therapy
Background:
- Continuous ambulatory peritoneal dialysis (CAPD) is underutilized in India.
- Chronic renal failure (CRF) necessitates effective renal replacement therapies.
Purpose of the Study:
- To evaluate the efficacy and safety of CAPD in Indian patients with CRF.
- To compare the incidence of peritonitis between standard straight and Y-sets.
Main Methods:
- Twenty CRF patients were initiated on CAPD, with 10 using the standard straight set and 10 using the Y-set.
- Laboratory parameters were assessed at baseline and after three months.
- Peritonitis incidence and patient outcomes were monitored over one year.
Main Results:
- Significant improvements were observed in blood urea, serum creatinine, bicarbonate, calcium, phosphorous, hemoglobin, and blood pressure.
- Serum lipid and protein levels showed significant deterioration.
- The Y-set had a significantly lower peritonitis incidence (1 episode/19.33 patient months) compared to the standard set (1 episode/5.92 patient months).
- Peritonitis occurred more frequently during summer months.
Conclusions:
- CAPD is a safe and viable renal replacement therapy for developing countries like India.
- The Y-set is associated with a reduced risk of peritonitis.
- Patient adherence was 70% at one year, with mortality linked to malnutrition, myocardial infarction, and tunnel infection.