Excellent technique survival on home peritoneal dialysis: Results of a regional program

Objective: To examine peritoneal dialysis technique survival in our regional, continuous ambulatory peritoneal dialysis (CAPD) program. Design: Retrospective analysis. Setting: Tertiary care dialysis program at an academic medical center. Patients: 155 patients representing all those in the peritoneal dialysis program between October 1, 1987 and October 1, 1990. Outcome measures: The study analyzed patient and technique survival as well as the reasons for discontinuation of dialysis. In addition, the incidence and type of peritonitis and exit-site infection were also analyzed. Results: Three-year actuarial patient survival was 66% and three-year technique survival was 86%, with data censored for death and transplant patients. Fifty-seven percent of transfers to hemodialysis were due to peritonitis, usually fungal or multiorganism bacterial. Only 1 patient failed due to exit-site and tunnel infection, and 1 due to inadequate dialysis. The catheter removal rate was 0.04 per patient-year. Conclusions: Excellent CAPD technique survival can be achieved if exit-site and tunnel infection rates are low.