Prevention of peritonitis with disconnect systems in CAPD: a randomized controlled trial. The Mexican Nephrology Collaborative Study Group

Kidney Int. 1998 Dec;54(6):2123-8. doi: 10.1046/j.1523-1755.1998.00190.x.


Background: Recently, disconnect systems for CAPD that are associated with a reduced frequency of peritonitis have been introduced. Our objective was to compare the incidence of peritonitis using three current CAPD systems in a high-risk population with low educational and socioeconomic levels, and high prevalence of malnutrition.

Methods: In a prospective controlled trial, 147 patients commencing CAPD were randomly assigned to one of three groups: 29 to the conventional, 57 to the Y-set, and 61 to the twin bag systems. The number of peritonitis episodes was registered, and patients were followed up for an average of 11.3 months.

Results: The average peritonitis-free interval for the conventional group was 6.1 months, for the Y system was 12.0 months, and for the twin bag was 24.8 months (P < 0.001). By multivariate analysis, the only factor associated with peritonitis was the CAPD system. Peritonitis-related hospitalization was 5.3 +/- 2.0, 2.7 +/- 1.0, and 1.5 +/- 0.9 days/patient/year in the conventional, Y system, and twin bag groups, respectively. The cost per bag was similar for the conventional and Y system, but higher for the twin bag. However, the total costs of treatment (pesos/patient/year) were lower for twin bag (62,159 for the conventional, 70,275 for the Y system, and 54,387 for the twin bag), due to the lower peritonitis incidence and associated hospitalizations.

Conclusions: Y system and twin bag use was associated with a reduction of 50 and 75% peritonitis incidence, respectively, in patients on CAPD. The cost of the twin bag was actually lower, because of savings from a decreased usage of antibiotics and fewer hospitalizations.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Equipment Design
  • Female
  • Health Care Costs
  • Hospitalization
  • Humans
  • Incidence
  • Length of Stay
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Peritoneal Dialysis, Continuous Ambulatory / adverse effects*
  • Peritoneal Dialysis, Continuous Ambulatory / economics
  • Peritoneal Dialysis, Continuous Ambulatory / instrumentation
  • Peritoneal Dialysis, Continuous Ambulatory / methods*
  • Peritonitis / epidemiology
  • Peritonitis / prevention & control*
  • Prospective Studies