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Outcome and complications in patients treated with continuous ambulatory peritoneal dialysis (CAPD) at a single
G J Wanten1, M I Koolen, F J van Liebergen
1Department of Internal Medicine, Bosch Medicentrum, Hertogenbosch, Netherlands.
Insights
Continuous ambulatory peritoneal dialysis (CAPD) patient survival rates were evaluated, showing significant complications like peritonitis and technical issues that threaten treatment success despite reduced infection rates.
Area of Science:
- Nephrology
- Internal Medicine
- Medical Technology
Background:
- Continuous ambulatory peritoneal dialysis (CAPD) is a treatment for end-stage renal disease.
- Complications such as peritonitis and technical failures can impact treatment outcomes.
Purpose of the Study:
- To assess patient outcomes and complication rates in CAPD treatment.
- To identify factors affecting patient and technique survival.
Main Methods:
- A retrospective study reviewed data from 123 CAPD patients treated between 1982 and 1994.
- Patient survival, catheter survival, and complication incidences were analyzed.
Main Results:
- Patient survival at 1, 2, 3, and 5 years was 89%, 78%, 69%, and 50%, respectively.
- 179 technical complications and 220 peritonitis episodes were recorded.
- Gram-negative peritonitis was linked to higher mortality and treatment termination.
Conclusions:
- Infectious and technical complications remain significant challenges in CAPD.
- While new methods reduced peritonitis, overall patient and technique survival did not improve.
Objective:
To evaluate outcome and complications in patients treated with CAPD at our centre a retrospective study was performed.
Methods:
Relevant data from all 123 consecutive patients on the CAPD program from 1982 to 1994 were reviewed.
Results:
Patient survival after 1, 2, 3 years was 89, 78, 69 and 50% respectively. The probability of having a functioning catheter after 1, 2, 3 and 5 years was 90, 77 and 68%, respectively. We observed 179 technical complications (42 intra-abdominal pressure, 137 catheter-related). Peritonitis (220 episodes, 62% gram-positive) occurred with a mean incidence of 1 episode in 13 treatment months and was the main reason (26 cases, 68% gram-positive) for catheter removal. (Mixed) Gram-negative peritonitis was associated with a higher mortality, and relatively more often resulted in termination of CAPD treatment when compared to gram-positive peritonitis. Introduction in 1988 of a new fluid exchange system (Twin Bag) and alcohol disinfection of hands was accompanied by a decreased incidence of peritonitis and exit-site infections, but to date patient, technique and catheter survival have not improved.
Conclusion:
Although therapeutic measures have resulted in a reduced incidence of peritonitis and exit-site infections, infectious and technical complications remain a serious threat to patient and technique survival in CAPD treatment.
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