Comparison of peritonitis rates using standard spike versus Y sets in CAPD

Peritonitis is a major source of morbidity for CAPD patients. The "Y" set, which incorporates a "flush before fill" concept, would theoretically decrease peritonitis rates. During Period I 16 new patients began CAPD using the standard spike procedure (Group I). During Period II 10 patients began CAPD using the Y set (Group II). Peritonitis episodes and concomitant exit site infections (ESI) were noted. Time to the first episode of peritonitis (EOP) was estimated using Kaplan-Meier plots; each group was followed for 15 months. In Group I there were 25 EOP in 145.6 patient-months, with three EOP associated with ESI. In Group II there were 3 EOP in 92.77 patient-months and 2 EOP associated with ESI. When the total EOP were considered there was 1 EOP every 5.82 patient-months (Group I) versus 1 EOP every 30.9 patient-months (Group II) (P = 0.0015). When EOP associated with ESI were excluded, peritonitis rates were 1 EOP every 6.61 patient-months (Group I) versus 1 EOP every 92.77 patient-months (Group II) (P = 0.0003). Difference in estimated time to first EOP using Kaplan-Meier plots was also statistically significant for Group II versus Group I (P = 0.0246). The Y set resulted in a statistically significant reduction in peritonitis rates.