One hundred and ninty-one patients with end stage renal disease were treated with CAPD over a period of 4.4 years between Mar. 1981 and July 1985. A total of 594 episodes of peritonitis occurred during 189.92 patient-years of CAPD with the incidence of peritonitis at 3.13 per patient-year. The incidence of peritonitis has declined progressively during the past 5 years: 6.13 episodes per patient-year in 1981, 4.46 in 1982, 3.99 in 1983, 2.99 in 1981 and 2.25 in 1985. Of the 109 patients who were on CAPD for 6 months or over, 81 patients had no peritonitis for at least 6 months, 19 patients for 12 months, 9 patients for IS months and 1 patient for 2.1 months. Peritonitis was responsible for 7.0 days of hospitalization per patient-year or 20.1% of total hospital stay. Peritonitis was successfully treated on outpatient basis in 64.6°o and by antibiotics only in 82.3 Peritoneal catheter had to be removed once in every 5.7 episodes of peritonitis. Staphyloccus was the most common organism isolated from peritoneal
fluid, catheter tip and catheter exit site. A total of 85 episodes(22.0% of all catheters) of catheter exit-site or tunnel infection occurred during the same period. In 34.1,°0 of these infections peritonitis followed. Peritoneal catheter had to be re-moved in 30 episodes(25,3%): in 20 episodes because of associated peritonitis. Improvement in skin hygiene and connecting technology will reduce staphylococcal infection. It is also anticipated that better understanding of peritoneal defense mechanism will lead to further reduction of peritonitis.
|