Continuous ambulatory peritoneal dialysis

CAPD has stimulated much interest because of conceptual and practical developments over the last decade. The growth of CAPD also demonstrates that hemodialysis as practices at the present time is not completely satisfactory for many patients and CAPD helps to fill a need. CAPD may not be the ultimate favorite in most patients, but may continue to offer an alternate approach to special problems. Careful controlled studies of long-term experiences with CAPD are needed. The initiation of a CAPD program should be done with extensive planning and care. CAPD is still a technique that can only be offered by specialists experienced in all of the complicated aspects of medical care in dialysis patients. Because this technique is spreading so rapidly and yet is still in its infancy, I would strongly urge cooperative studies of new devices and solution modifications to truly establish their worth and to control the spread of expensive but unproven gadgets. Also, there is an important need for a national registry of CAPD. The unfortunate demise of the hemodialysis registry and the transplant registry in this country at least took place after some years of monitoring and maturation of these techniques. The national experiences with CAPD should be shared to nurture the maturation of this promising but still evolving technique.