An analysis of peritonitis rates with bagless continuous ambulatory peritoneal dialysis (CAPD)

This study was performed to evaluate if the increased number of connections needed to perform bagless continuous ambulatory peritoneal dialysis (CAPD) with the Delmed system was associated with an increased incidence of peritonitis. All patients, from April 1986 through October 1988, using the Delmed bagless connection system, the Delmed bag system, and the Abbott spike system were included. Fifty patients (42.7 years at risk) received bagless CAPD (53 episodes of peritonitis; 1.24 episodes/patient year of dialysis); 56 patients (46.8 years at risk) utilized the Delmed bag technique (76 episodes of peritonitis; 1.63 episodes/patient year); and 45 patients (66.7 years at risk) utilized the Abbott system (155 episodes of peritonitis; 2.36 episodes/patient year of dialysis). The time to the first peritonitis episode was not significantly different between groups. Fifteen patients were switched from the Abbott system (2.3 episodes/patient years) to the Delmed bagless system (0.9 episodes/patient year, peritonitis; p less than 0.05) and 9 patients were switched from the Abbott spike system (2.3 episodes/patient years) to the Delmed bag system (1.4 episodes/patient years; p less than 0.01). It is concluded that the Delmed bagless system is not associated with an increased incidence of peritonitis and that the Delmed system is at least as good as the spike connection devices.