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Chronic peritoneal dialysis: mechanical and infectious complications
Nephron
|January 1, 1985
Summary
Continuous ambulatory peritoneal dialysis (CAPD) has more infectious complications like peritonitis than intermittent PD (IPD). However, mechanical issues are similar, and most complications can be managed without stopping dialysis.
Area of Science:
- Nephrology
- Medical Devices
- Infectious Diseases
Background:
- Chronic peritoneal dialysis (PD) utilizes devices and procedures that can lead to mechanical and infectious complications.
- Understanding the differences in complication rates between continuous ambulatory PD (CAPD) and intermittent PD (IPD) is crucial for patient management.
Purpose of the Study:
- To compare the type and frequency of mechanical and infectious complications in patients undergoing CAPD versus IPD.
- To assess the manageability of these complications and their impact on the continuation of chronic PD.
Main Methods:
- A comparative analysis of complication data from contemporaneous patient groups undergoing CAPD and IPD.
- Categorization of complications into mechanical (catheter-related, pressure-related) and infectious (peritonitis).
Main Results:
- Mechanical complications related to the catheter and its placement were similar between CAPD and IPD.
- Increased intraperitoneal pressure led to more frequent mechanical complications in CAPD.
- Peritonitis occurred significantly more often in CAPD (1.6 episodes/patient-year) than IPD (0.4 episodes/patient-year).
- Risk factors for peritonitis include diabetes, childhood, WBC abnormalities, and early treatment phase.
Conclusions:
- While mechanical complications are comparable, CAPD presents a higher risk of peritonitis.
- Most mechanical complications and peritonitis episodes can be managed conservatively, allowing PD to continue.
- Specific pathogens like fungi, Pseudomonas, and certain staphylococci may require tailored treatment approaches.