CONTINUOUS AMBULATORY PERITONEAL DIALYSIS: A SINGLE CENTRE EXPERIENCE IN SRI LANKA

Introduction and Objectives

Chronic kidney disease (CKD) has become a serious health burden in Sri Lanka. With the limited resource facilities government cannot provide hemodialysis for all end stage renal disease (ESRD) patients. We have introduced continuous ambulatory peritoneal dialysis (CAPD). The objective of this paper is to report the experience of CAPD at a tertiary care hospital.

Method

We report a retrospective study carried out in the Nephrology and Transplant unit, Teaching hospital Kandy. This study involved 256 patients who were initiated on CAPD between October 2014 and October 2018.  Selected patients were included into a comprehensive program encompassing counseling, medical and social assessment, training, providing infrastructure support and monitoring. CAPD associated complications were also studied.

Results

A total of 256 patients (160 males, 96 females) were included in the study. The age varied from 17 to 78 years. Currently, 144 patients (male 92, female 52) are continuing CAPD, while 24 patients have had kidney transplant, 12 patients shifted to haemodialysis, 18 patients had catheter removal due to associated complications, 24 patients was lost to follow-up, and 34 patients died during the study period.

Reasons for catheter removal were recurrent peritonitis (n=9), fungal peritonitis (n=4), catheter blockage (n=4) and considered conservative management (n=1). The main causes of death were cardiovascular complications and sepsis.  Altogether, 132 episodes of peritonitis were recorded involving 81 patients (56 male and 25 female). Exit-site infections were observed in six patients.  Several local complications were encountered (4 cases of inguinal hernia, 3 cases of umbilical hernia and 2 cases of catheter site hematoma)

Conclusion