Rescue plan for CAPD peritonitis: Using ultrasonography as a guide on when to remove the catheter
Dusit Lumlertgul1,2,3,4, Nantawan Tinroongroj1,5, Suthaporn Lumlertgul1,6
1CAPD Institute, Chiangmai Kidney Clinic, Chiangmai, Thailand.
Introduction:
Ultrasound has been found to facilitate early identification of peritonitis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).
Methods:
A retrospective analysis was carried out to evaluate the effectiveness of ultrasonography-guided removal of the Tenckhoff catheter in reducing complications like a shift to hemodialysis or death in CAPD patients.
Results:
The "peritonitis rescue plan" supported timely decision-making for the removal of the infected catheter and resulted in a lower peritonitis episode per patient per month ratio (from 1:36 to 1:122) in 2021, a lower death rate (from 19% to 6.6%) and lower incidences of shifts to hemodialysis (from 2%-9% to 0%) as compared to that before the implementation of the plan in 2019.
Conclusion:
The implementation of the "peritonitis rescue plan" and the removal of the infected catheter within 3 days of peritonitis being detected was successful in improving the standard of care for patients undergoing CAPD.
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