Korean Journal of Nephrology 1991;10(2):201-208.

Safe - Lock 연결관을 이용한 CAPD의 임상성적에 관한 연구

이호영 , 김영기 , 김기용 , 손승환 , 김흥수 , 최규헌 , 한대석

Abstract

We investigated the effect of Safe Lock connecting system of CAPD in 34 ESRD patients from Feb. 1990 to Feb. 1991. Clinical and laboratory results were as fol- lows 1) The number of pateints was 34. Seventeen patients started CAPD using Safe Lock system and fifteen patients changed their previous spike connector to Safe Lock system. Two patients changed their dialysis modality form hemodialysis to CAPD using Safe Lock system. 2) The age distribution was 18-70 year-old with mean of 42.4 year-old and the sex ratio was 13:21(M:F). 3) Underlying diseases were 17 chronic glomerulone- phritis, 4 hypertension, 3 diabetes mellitus, 3 renal tuber- culosis, 2 membranous glomerulonephritis, 1 IgA ne- phropathy, 1 SLE and 1 gout. 4) Seventeen Patients who used Safe Lock system from the start of CAPD experienced peritonitis with the incidence of 0.41/patient/year, 0,62±1,77/year which were significantly lower than those of patients, who used spike connector more than 90 days with 1.51/ patient,"year and 2,01± 1.43/year respectively. 5) Incidence of peritonitis of 28 patients who had used Safe Lock system more than 90 days were 0.80/patient/ year and 1,04±1.93/year. These values are not significantly different from those of patients who used spike connector more than 90 days. 6) Patients who changed connecting system from spike connector to Safe Lock system showed that the incidence of peritonitis during the use of spike conn- cector were 1.74/patient/year, 2.28±1.17/year and during Safe Lock system 1.43/patient/year, 1,64±1 79/ year. There was no statistical difference in incidence of peritonitis during each period. 7) Eighteen out of 34 patients experienced complica- tions during the use of Safe Lock system. Peritonitis were 18 times, abdominal pain in 11 patients, intraper- itoneal bleeding in 3 patients, exit site infection in 3 patients, adaptor disconnection in 2 patients, ratheter obstruction in 1 patient and catheter malposition in 1 patient. Eighteen peritonitis occurred in 10 patients and causative organisms were 2 gram positive bacterias, 7 gram negative bacterias, 1 fungus and 7 were culture negative. 8) Eight patients discontinued Safe Lock system. The causes were abdominal pain in 4 patients, renal trans- plantation in 2 patients and peritonitis in 2 patients. These 2 peritonitis cases included 1 fungal peritonitis with rectal bleeding and 1 sepsis with DIC. 9) Blood chemistry improved in 17 patients who start- ed CAPD with Safe Lock system. There were no significant changes of laboratory values in 17 patients who received other system of dialysis before the use of Safe Lock system. In conclusion, CAPD with Safe Lock connector system showed comparable effects of dialysis, lower tendency in the episodes of peritonitis and was very easy in bag exchange compared to the conventional spike system. But further study will be neede for the evalua- tion of the abdominal pain and long term effect in the prevention of CAPD peritonitis with this safe Lock eonnector system.