[Role of peritoneal dialysis in the treatment of terminal chronic renal insufficiency. Survival of patients and method]. / Place de la dialyse péritonéale dans le traitement de l'insuffisance rénale chronique terminale. Survie des patients et de la méthode.

Chronic peritoneal dialysis, especially continuous ambulatory peritoneal dialysis, is now a modality of treatment for patients with end stage renal failure. The proportion of patients varies considerably from country to country. Non medical considerations seem to be the main reason for the limited development of the treatment modality. Most of available reports point out no difference in patient or technique survivals on hemodialysis or peritoneal dialysis. Age, diabetes mellitus, cardiovascular diseases, infections complications (peritonitis and exit-site infections) impact on mortality and morbidity (number of hospital days per patient per year). The probability of death or dropout is much higher for patients with diabetes and patients in older age groups. Most patients with end stage renal failure, especially those waiting for a kidney transplant, are suitable for peritoneal dialysis.

[Prevention of peritonitis in continuous ambulatory peritoneal dialysis]. / Prévention des péritonites en dialyse péritonéale continue ambulatoire.

The reduction in the peritonitis rate over recent years has been obtained as a result of the use of disconnectable systems in patients treated by continuous ambulatory peritoneal dialysis. This complication was previously one of the major reasons for withdrawal from the treatment. The reduction in peritonitis would appear to be due, in particular, to the flush effect performed in all of the patients using a Y-set system.