A prospective, randomized study comparing the peritonitis incidence of CAPD and Y-connector (CAPD-Y) with continuous cyclic peritoneal dialysis (CCPD)

Abstract

Both CAPD-Y and CCPD have been reported to reduce the high peritonitis rate of conventional CAPD. As peritonitis was the major complication of CAPD in our centre, both modifications were introduced in 1987. Initially, treatment modalities were allocated to patients based on their (doctor's) preference. A remarkable difference in peritonitis rate was encountered between patients on CCPD and those on CAPD-Y (0.6 vs 1.2 episodes a year). As patient selection and doctor's preference might have contributed to this hopeful result, a prospective study was started. From January 1988 on, all new patients were at random assigned to CAPD-Y or CCPD in order to study the incidence of peritonitis in relation to the treatment modality. Up till November 1, 1990, 26 patients enrolled in the CAPD-Y group (follow-up of 292 patient months), and 30 patients in the CCPD group (follow-up of 337 patient months). This ongoing study reveals that CCPD patients remained peritonitis free significantly longer than those on CAPD-Y (quartile time to first peritonitis greater than 12 vs 3 months, p less than 0.05), and had a significantly lower peritonitis incidence (median time to second peritonitis 18 vs 6 months, p = 0.016). In conclusion, in an unselected patient population CCPD was accompanied with a significant lower peritonitis incidence than CAPD-Y.