A Comparative Study of Three Connector Systems in Continuous Ambulatory Peritoneal Dialysis(CAPD) Related Peritonitis / 대한내과학회지

ABSTRACT

OBJECTIVES: The purpose of the present study was to compare the general condition of peritonitis through a study of three connector systems The Straight transfer set with Spike-and-Pork system(SPS), The Straight transfer set with Luer-Lock system(SLS), and The Y-set with Two Bag system(YS). METHODS: We reviewed our experience with 134 patients from 1988.1 to 1995.12. According to various kinds of connector system, we divided cases into 3 groups The SPS(1988. 1-1991. 3) was used on 55 patients(mean age 47+/-2, MF=3025); The SLS(1991.4-1993.8) on 45 patients(mean age 55+/-1, MF=3015); and The YS(1993.9-1995.12) on 34 patients(mean age 49+/-5, MF=1519). RESULTS: 1) Total CAPD duration was 1.22 patient year in SPS, 1.08 in SLS, and 0.96 in YS. The incidence of peritonitis is 1.71 episodes per patient year in SPS, 1.03 in SLS, and 0.61 in YS. 2) Among the causative organisms of peritonitis, coagulase negative Staphylococcus was most common in the three groups(SPS10.4%, SLS10%, YS20%). In SPS and SLS, S. aureus(7.7%, 8%), Pseudomonas(6.5%, 8%), E. coli(5.2%, 6%) were present in decreasing order. In YS, Pseudomonas (15%), S. aureus(15%), E. coli(10%) were present in decreasing order. There were no growth of organisms in 55.9% of SPS, 38% of SLS, and 30% of YS. 3) The probability of experiencing the first peritonitis at 1, 3, 6, and 12 months was 21.4%, 21.4%, 21.4%, and 23.9% respectively in SPS, 3.4%, 34.5%, 34.5%, and 10.3% respectively in SLS, and 0%, 28.5%, 35.7%, and 28.5% respectively in YS. 4) In the response to the treatment of peritonitis, 59.7% of the peritonitis episodes in SPS, 72% in SLS, and 85% in YS were cured with antibiotics. In 37.7% of the peritonitis episodes in SPS, 24% in SLS, and 10% in YS, the catheter was removed due to fungal, tubercolous, recurrent, or peritonitis not responding to antibiotics. 2 patients in SPS, 2 patients in SLS, and 1 patient in YS died due to peritonitis. 5) The catheter survival rate at 3, 6, 12 months was 72%, 63.6%, and 40% respectively in SPS, 89%, 78.3%, and 46.7% respectively in SLS, and 94%, 85.3%, and 76.6% respectively in YS. CONCLUSION: Our study suggests that there is a relationship between the development of connector system and a decrease of peritonitis in CAPD.