Continuous cyclic peritoneal dialysis (CCPD) was designed to reduce the high incidence of peritonitis and eliminate the multiple interruption created by dialysis exchanges during the day needed for CAPD, while maintaining the quality of dialysis. Three nocturnal cycles with 2 liters of dialysate lasting 3 hours each are provided by an automated cycler while the patient sleeps. Two liters are left in the abdomen in the morning. Only one daily connection and one disconnection are required between the peritoneal catheter and the cycler line. Our 84 patient months experience with 14 patients reveals a low incidence of peritonitis (1 per 42 patient months), satisfactory ultrafiltration rates and clearances that compare favorably with those of CAPD (Curea 67, Ccreatinine 58, and CB12 45 L/wk). Blood pressure control has been excellent while most patients enjoy liberal diets. This preliminary study suggests that CCPD may indeed reduce the rate of peritonitis, provide excellent clearance and ultrafiltration, allow more free time to the patient and maintain a steady physiological state.

The experience with intraperitoneal infusion of non-absorbable steroids (triamcinolon hexacetonide) in the treatment of intractable hemodialysis-associated ascites and severe sterile peritonitis is presented. All patients uniformly responded to therapy with prolonged periods of remission and no significant complications. We conclude that intraperitoneal steroidal administration offers an effective modality of therapy in the treatment of these complications.

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