1990 Volume 23 Issue 1 Pages 89-92
Continuous ambulatory peritoneal dialysis (CAPD) is now being accepted as a treatment for end-stage renal disease (ESRD). Since diabetic patients often have systemic complications, CAPD should be recommended as a treatment rather than hemodialysis. A number of diabetics are, however, excluded from CAPD because of technical difficulties due to concomitant complications, such as visual disturbance, muscle weakness, and incomprehension of the practice of CAPD, especially in the elderly.
An ultraviolet germicidal CAPD exchange device (UV-XD) has been developed, which disinfects the spike and outlet of the dialysate bag before spike insertion, and insertion or extraction of the spike is performed with a mechanical lever.
From 1987, 5 diabetic ESRD patients were introduced to CAPD therapy using UV-XD. During a treatment period of 80.3 patient·months no peritonitis was observed in these patients, while four episodes of peritonitis occurred in 18 patients using the conventional manual exchange technique during 105.6 patient·months. Although no statistically significant difference was found in the cumulative probability of peritonitis by Kaplan-Meier's method between the two groups, the usefulness of UV-XD was recognized for patients who were not able to perform CAPD previously.
We expect an increase in CAPD therapy in diabetic patients with ESRD by means of UV-XD.
