THE PROBLEMS OF PERITONEAL-DIALYSIS IN THE MANAGEMENT OF CHRONIC UREMIA IN NIGERIA

The problems encountered in the use of peritoneal dialysis (PD) in the initial management of patients with chronic renal failure in Nigeria were highlighted, studying 23 patients (13 males and 10 females) aged between 15 and 68 years (mean age 36.4 years). Peritonitis was the mos t common complication, occurring in 16 (70%) of patients; effluent dra inage obstruction in 11 patients (48%); haemorrhagic effluent in 10 pa tients (44%); fluid leak from catheter site infection in 7 patients (3 0%); accidental disconnection of line/catheter joint in 5 patients (22 %); and catheter site infection in 2 patients (9%). A positive effluen t culture was found in only 4 out of 18 cultured samples, with Klebsie lla and Staphylococcus aureus being the organisms isolated. Dialysis w as terminated in patients for the following reasons: financial constra ints (8 patients), unresolving peritonitis (7 patients), drainage prob lems (3 patients), and clinical improvement (5 patients). The study co ncludes that PD in the management of chronic uraemia in developing cou ntries, while producing clinical benefits in the majority of patients, is still not generally acceptable as a long-term treatment modality i n view of the number a problems.