Reduced incidence of peritonitis by utilizing "flush before fill" in APD

Studies first theorized and then proved that "flush before fill" decreased the incidence of peritonitis in continuous ambulatory peritoneal dialysis (CAPD). The purpose of this study was to examine the relationship between the incidence of peritonitis and the use of cyclers with the "flush-before-fill" option. We followed our automated PD (APD) population from 1 August 1994 to 30 September 1996. The patients were divided into two groups. Group I utilized cyclers with the "flush-before-fill" option and experienced 8 incidences of peritonitis in 225 patient-months of use, for a peritonitis rate of 1:28. Group II utilized cyclers without the "flush-before-fill" option and experienced 22 incidences of peritonitis in 225 patient-months of use, for a peritonitis rate of 1:10.2. Gram-positive organisms were responsible for 3/8, or 37.5%, of incidences of peritonitis for Group I and 13/22, or 59%, of peritonitis incidence for Group II. The results of the study indicate a reduction in both the incidence of peritonitis and the incidence of peritonitis caused by gram-positive organisms for APD when utilizing cyclers with the "flush-before-fill" option.