Is peritonitis a limiting factor in the widespread use of CAPD in the developing countries ?

Although continuous ambulatory peritoneal dialysis (CAPD) is now an established form of treatment for patients with end-stage renal failure (ESRF), it is not being used on a large scale in developing countries (DC). One of the limiting factors in this regard is peritonitis which is the most common complication of CAPD. Data on 70 patients on CAPD in our center were analyzed to study the impact of peritonitis on long-term outcome of this treatment. The mean age of the study patients was 37.2 years and the mean follow-up was 32.8 months per patient. A total of 41 patients (58.6%) received CAPD as first choice, 27 (38.6%) were started on CAPD after being on hemodialysis earlier and two (2.8%) were started on CAPD after a failed renal transplantation. Thirty three patients (47.1%) used safe-leur lock system, 23 (32.9%) used the spike system and 14 (20%) used safe-leur system initially and subsequently were changed to spike system. The overall incidence of peritonitis encountered was one episode per 32.3 patients months and was higher among patients who started CAPD as second choice. The incidence of peritonitis was not influenced by sex, age, profession or presence of diabetes mellitus or cardiovascular disease. This study shows that peritonitis rate in CAPD patients in our hospital is low and compares favorably with results from established centers in the developed countries. Thus, worries about recerrent peritonitis should not hinder CAPD programs in DC.