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Six-And-A-Half Years of Experience with Three Two-Liter Daily Exchanges in CAPD

Our continuous ambulatory peritoneal dialysis (CAPD) program consists of three 2- L daily exchanges (usually two of 1.5% and one of 4.25% dextrose concentration). Between March 1981 and November 1987, 87 patients were started on this program. Mean age was 35 years, 55% were males, and mean follow-up was 20.1 ± 2 months for a total experience of 1748 patient months. At the end of the study, 27 (31%) were still on CAPD, 43 (49.5%) had received renal transplants, 8 (9.2%) had returned to hemodialysis, 6 (6.9%) had been transferred to other units, 2 (2.3%) died, and 1 (1.1%) voluntarily quit. Actuarial survival rates were 90%, 81 %, and 57% for patients, method, and catheters, respectively, at 66 months. Peritonitis appeared at a rate of one episode per 14 patient months for a total of 121 episodes occurring in 51 patients. Rates of other complications were not higher than those reported by others. Hospitalization rates were low. Hypertension improved, patient weight did not change, and laboratory data tended towards normal levels or normalized. In selected patients, three 2- L exchanges per day appear to be enough for an adequate CAPD, even for long-term treatment. At the same time, it allows a 25% reduction in cost and risk of peritonitis. Larger number of patients and longer follow-up periods will be required to exactly define its real usefulness and safety.