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Update on continuous ambulatory peritoneal dialysis

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Ricerca in clinica e in laboratorio

Summary

By now many patients have been successfully maintained on CAPD for five years or more, thus demonstrating that CAPD is a viable long-term treatment for end-stage renal disease. Peritonitis—the main concern of the earlier years—is now a less frightening complication. We know better how to treat peritonitis and its incidence has decreased from one episode every 8 months initially to one episode every 18 months now. In addition, several innovations, which have been or soon will be introduced, promise to decrease the frequency of peritonitis to an even lower rate. The problem of peritonitis is now being replaced by the chronic complications of CAPD, predominantly malnutrition and decrease in peritoneal ultrafiltration. CAPD has become an important adjunct in the treatment of children with ESRD, especially the very young. Even though not normal, their growth on CAPD is better than that of children on hemodialysis and as good as that after a successful transplant. CAPD has become a promising treatment for the diabetic with ESRD. This experience has stimulated interest and research in the role of intraperitoneal administration of insulin for blood glucose control. With the present worldwide experience of CAPD, this treatment has ceased to be experimental. A percentage of patients requiring dialysis will be better off on CAPD than on hemodialysis. Even though this percentage will vary among various countries, the nephrologist who wants to provide the best treatment for each patient must be well experienced in and have all treatments at his disposal including CAPD.

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Authors and Affiliations

  1. Departments of Medicine and Microbiology Peritoneal Dialysis Unit Division of Nephrology, Toronto Western Hospital and University of Toronto, 399 Bathurst Street, M5T 288, Toronto, Ontario, Canada

    Ramesh Khanna, George Wu, Stephen I. Vas, George Digenis & Dimitrios G. Oreopoulos

Authors
  1. Ramesh Khanna
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  2. George Wu
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  3. Stephen I. Vas
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  4. George Digenis
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  5. Dimitrios G. Oreopoulos
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Additional information

Part of this work was supported by the National Institutes of Health, Artificial Organs-Chronic Uremia Program (N01-AM-8-2213) and the Peritoneal Dialysis Research Fund of the Toronto Western Hospital.

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Khanna, R., Wu, G., Vas, S.I. et al. Update on continuous ambulatory peritoneal dialysis. La Ricerca Clin. Lab. 13, 381–395 (1983). https://doi.org/10.1007/BF02906919

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