[Continuous ambulatory peritoneal dialysis]

Abstract

In contrast with hemodialysis (HD) Continuous Ambulatory Peritoneal Dialysis (CAPD) is a permanent dialysis procedure proposed to the chronic renal patients. Through a permanent peritenoal catheter the patients exchange 2 litres of dialysate 4 times a day, 7 days a week, as soon as the dialysat/plasma concentration for urea reaches 1. Inflow and outflow of the fluid is obtained by gravity, without machine. The short term survival rate is comparable between HD and CAPD. After 5 years, some patients, loosing the residual renal function, need to increase the possibilities of CAPD. The recent disconnect systems reduce the rate of peritonitis down to 1 episode every 36 months. With the actual technology the severe complications such as sclerosing peritonitis decrease or even disappear. Maintenance of an adequate nutritional status in the patients remains an often difficult problem. CAPD may be proposed to nearly all the patients who prefer to be treated at home: children, working adults, diabetics and elderly. Long term studies are still needed to follow the peritoneal performances over time.