Algrim-Boyle C, Zeigler N, Ristow T, Putignano P, Vonesh E,
Blazer J, Moran J
An evaluation of the causes which lead to transfer from peritoneal
dialysis
17th Annual CAPD Conference
Perit Dial Int Suppl 1
(Feb) 17:S55 1997
This study from Baxter USA looks at the reasons that led to 253
patients discontinuing PD at 94 different units during March 1996.
Data obtained is based on a phone survey with a PD nurse at each
unit. The investigators find that 49% of the 253 patients leaving PD
died, and that in over one-third of these the cause of death was
cardiac, with the second commonest cause being infection in just
under one-quarter of the patients. Among the 51% of patients who left
PD to switch to hemodialysis, 37% were due to peritonitis, 9% to
inadequate dialysis and 9% to catheter problems. The remainder were
due to a variety of reasons. It was notable that the commonest
causes of peritonitis leading to modality switch were fungi in 28% and
multiple organisms in 15%.
The authors conclude that peritonitis remains a major cause of PD
failure despite the introduction of new and better disconnect
systems. It could, of course, be argued that the newer disconnect
systems have led to a decrease only in the less severe forms of
peritonitis such as those due to touch contamination [eg, Staph
epidermidis]. It is notable that, from all the attention it
receives, only 9% of patients switching to hemodialysis did so
because of so-called "inadequate PD". It should, however, be pointed
out that many of the 15% who switched for "other medical" reasons and
that the 29% switched for "other" reasons may include cases where
inadequate dialysis was a contributor to the adverse outcome. The
most important point about this study, however, is that it
re-emphasizes the fact that peritonitis remains a major problem in PD
patients. (Peter G. Blake, M.D., Victoria Hospital, London,
Ontario)
To go back use the BACK button on your browser.
Otherwise click on the desired link to this article below:
17th Annual CAPD Conference
CRF: Problem Areas :
Outcomes (Morbidity, Mortality)
Basic peritoneal dialysis :
Complications of PD