A Multicenter Study of CAPD-Related Peritonitis in Japan

抄録

In Japan, there were 2, 961 dialysis facilities with 167, 192 patients on dialysis at the end of 1996. Continuous ambulatory peritoneal dialysis (CAPD) therapy was provided in 1, 035 facilities (35%) with 8, 715 patients (5.2%). Hemodialysis (HD) was much more frequently used than CAPD in the treatment of end stage renal disease (ESRD). Possible reasons for this include a larger number of facilities with more established treatment protocols for HD as compared to those for CAPD, A high incidence of infections specific to this modality, and a decreased peritoneal membrane function were frequently observed in long-term CAPD patients. We carried out a survey of 1, 308 prevalent patients, which was equivalent to 15% of CAPD patients in Japan, from 23 dialysis facilities, over a 2-year period from October 1, 1994 to the end of September, 1996. Data collected included cause of peritonitis, etiologic microorganism, treatment method, and prognosis of CAPD related-peritonitis. The incidence of peritonitis was one episode in 53.3 (20.4-272.6) patient months, that is 0.23 episodes/patient year, showing a remarkable decrease as compared to the result of a comparable survey conducted in 1986. Although there was significant center variability in the incidence of peritonitis, improved device and improved patient education by in-center staff were reported as presumably important factors contributing to the reduction in the incidence of peritonitis. The first line of antibiotics therapy for treatment was vancomycin in accordance with the 1993 Ad Hoc Committee recommendations.