CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS - AN OPTION IN THE DEVELOPING-WORLD

Objective: To evaluate specified biomedical, socioeconomic, and psycho social criteria as predictors of therapeutic success to optimize patie nt selection for continuous ambulatory peritoneal dialysis (CAPD) in a developing country. Design: A restrospective cohort study investigati ng the relationship between episodes of peritonitis and exit-site infe ction, and predetermined biomedical, socioeconomic, and psychosocial d ata. Setting: A CAPD unit in a large tertiary care teaching hospital. Patients: All 132 patients entering the CAPD program between 1987 and 1991. Results: Overall mean survival time on CAPD was 17.3 months. Per itonitis rates were high, especially among blacks. Multivariate analys is demonstrated that increased peritonitis rates were associated with age, black race, diabetes, and strongly so with several psychosocial f actors. Because being black was strongly linked to poor socioeconomic conditions, repeat analysis excluding blacks showed the same associati ons with the above variables, but, additionally, several socioeconomic factors were associated with high peritonitis rates. No significant e xplanatory variables were shown for exit-site infections. Conclusions: The association of biomedical, socioeconomic, and psychosocial variab les with high peritonitis rates has important implications for the sel ection of patients for CAPD in this setting.