Status Report on Continuous Ambulatory Peritoneal Dialysis in End-Stage Renal Disease

Several new trends in the treatment of patients with end-stage renal disease have begun to emerge in the last few years. Most notable has been the reintroduction of peritoneal dialysis (PD) as a long-term treatment option. The increased use of PD is the result of the development of a long-term indwelling peritoneal catheter, automated dialysate delivery systems, and the view by some investigators that, in certain patients, PD as compared with hemodialysis may be a preferred mode of therapy. In 1978, continuous ambulatory peritoneal dialysis (CAPD) was introduced and demonstrated to be an alternative to traditional intermittent peritoneal dialysis (IPD).1With CAPD, the patient instills the dialysis solution for four to six hours and exchanges the solution four to five times per day, six or seven days per week. Thus, while the efficiency of dialysis per hour is less with CAPD than with IPD, the clearances per week of