Continuous Ambulatory Peritoneal Dialysis – Developments during Changing Times

Abstract

Introduction: Continuous ambulatory peritoneal dialysis (CAPD) treatment is subject to constant changes. Departing from this thesis, it should be analyzed in which respects CAPD treatment at the Heidelberg outpatient clinic has changed when considering demographic data, and CAPD-specific data including infection rates and clinical parameters. Materials and Methods: A retrospective study was carried out in the course of which a cohort of 67 CAPD patients treated before the year 2000 was compared with a cohort of 53 patients treated from the year 2000 on. Demographic data, CAPD-specific and clinical data at the commencement of treatment and data gathered during the observation period thereafter were recorded. Results: The patients of the more recent cohort were 5 years older. At the initiation of treatment, the volume of residual diuresis was higher in the patients treated from 2000 on than in those treated before. The blood pressure in patients belonging to the more recently treated group was also lower than the blood pressure of those treated before. The incidence of peritonitis and exit-site infections has decreased. On the other hand, the hemoglobin level has risen. Discussion: Compared to the past, many parameters have improved. Above all, the findings suggest that medical care and treatment have become better, probably as a result of the modified guidelines. The significant decrease in infections is probably also due to the use of the new dialysis fluids.

Risk factors for peritonitis related to peritoneal dialysis

“…Even though the rate of chronic peritoneal dialysis (CPD) associated peritonitis has decreased since CPD was fi rst described, peritonitis is still a frequent complication of peritoneal dialysis and the most common cause of increased morbidity and mortality in patients with peritoneal dialysis (1). Incidence and risk factors of peritonitis associated with peritoneal dialysis (PD) differ between countries and even between clinics in the same country.…”