Korean Journal of Nephrology 1985;4(1):60-66.

CAPD 중의 감염

황승덕 , 이희발

Abstract

One hundred and ninty-one patients with end stage renal disease were treated with CAPD over a period of 4.4 years between Mar. 1981 and July 1985. A total of 594 episodes of peritonitis occu- rred during 1B9. 92 patient-years of CAPD with the incidence of peritonitis at 3, 13 per patient- year. The incidence of peritonitis has declined progressively during the past 5 years: 6. 13 episo- des per patient-year in 1981, 4. 46 in 1982, 3.99 in 1983, 2.99 in 1984 a d 2.35 in 1985. Of the 109 patients who were on CAPD for 6 months or over, 81 patients had no pe itonitis for at least 6 months, 19 patients for 12 months, 9 patients for 18 months and 1 patient for 24 months. Peritonitis was res- ponsible for 7. 0 days of h'ospitalization per pa- tient-year or 20.1% of total hospital stay. Perito- nitis was successfully treated on outpatient basis in 64. 6% and by antibiotics only in 82. 3%. Peri- toneal catheter had to be removed once in every 5,7 episodes of peritonitis. Staphyloccus was the most common organism isolated from peritoneal fluid, catheter tip and catheter exit site. A total of 85 episodes(22.0%' of all catheters) of catheter exit-site or tunnel infection occurred during the same period. In 34. 1 % of these infections perito- nitis followed. Peritoneal catheter had to be re-moved in 30 episodes(35.8%): in 20 episodes because of associated peritonitis. Improvement in skin hygiene and connecting technology will reduce staphylococcal infection. It is also antici- pated that bett:er understanding of peritoneal de- fense mechanism will lead to further reduction of peritonitis.