Korean Journal of Nephrology 1987;6(2):36-44.
CAPD 중 복막염의 역학
Abstract
This retrospective multicenter cooperative study ana- lyses clinical data from 1,106 CAPD patients treated at22 dialysis centers over the past 6 years and 4 months' period between March 1981 and July 1987. This re- presents above 90% of all CAPD patients estimated from 81.5% of all centers known to have offered CAPD in Korea during the study period. At the end of the study period 57.7% were still on CAPD, 11.9% were tansferred to hemodialysis, 10.9% died while on CAPD and 3.6% discontinued CAPD and lost to followup. Of 171 patients who were transferred to hemodialysis or lost to followup after discontinuing CAPD, 117 patients or 68.4% did so because of peritoni- tis. During 1,343.3 patient-years of CAPD, 2,419 episodes of peritonitis developed at the rate of 1.80 episodes per patient-year. The first episode of peritonitis occurred within one week of beginning CAPD in 15.8%, whithin 4 wks in 35.6%, within 6 months in 79.7% and within 1 year in 94.4% of those who experienced peritonitis. Gram-positive organisms were responsible for 66.4% of all peritonitis episodes: Coagulase-negative Staphy- lococci (31.3%) being the most common organisms. The rate of positive culture was unacceptably low at 25.3%. Female sex, use of Peritosol and Tenckhoff single cuff catheter appeared to be risk factors for peritonits. Age and underlying diseases did not appear to be risk factors. The results of this study suggest that more efforts are needed to reduce peritonitis rates. Associated risk fac- tors for peritonitis should be identificed and Y-connec- tor andi'or measures to strengthen systemic and peri- toneal defense mechanisms should be evaluated in the future prospective studies.
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