PERITONITIS RATE - TRADITIONAL VERSUS LOW-CALCIUM DIALYSATE

The results of nonrandomized retrospective studies have suggested that low calcium dialysate (LCD; ionized calcium concentration 1.25 mmol/L ) is associated with a higher peritonitis rate than traditional dialys ate (TD; ionized calcium concentration 1,75 mmol/L). For this reason, 86 consecutive new continuous ambulatory peritoneal dialysis patients were randomized, in a single-blind fashion, to TD or LCD for 1 year. T he results were analyzed on an intention-to-treat basis, no matter wha t fluid or what modality of treatment was being used at the end of the year. The two groups were well matched at baseline. At 1 year, 28 of 43 TD patients were still on continuous ambulatory peritoneal dialysis (one had a catheter changed due to peritonitis), four had a working t ransplant, one had recovered renal function, nine had died, and one ha d been transferred to hemodialysis because of peritonitis. Twenty-seve n of 43 LCD patients were on continuous ambulatory peritoneal dialysis (one catheter change), nine had a working transplant, six had died, a nd one was on hemodialysis, There were 17 proven (33 possible) periton itis episodes in 417 patient-months in the TD group, In the LCD group, there were 17 (35 possible) episodes in 432 patient-months, The prove n peritonitis rate was 0.49 episodes/patient/yr in the TD group versus 0.48 episodes/patient/yr in the LCD group (P = NS), In conclusion, th ere is no controlled evidence that LCD is associated with a higher inc idence of peritonitis than TD. (C) 1995 by the National Kidney Foundat ion, Inc.