NOCTURNAL INTERMITTENT PERITONEAL-DIALYSIS

Automated methods of peritoneal dialysis have developed as alternative methods of treatment to CAPD. We review our experience of 47 patients treated with nocturnal intermittent peritoneal dialysis (NIPD). Patie nts receive a nocturnal exchange of 15-25 litres of dialysate with the peritoneum left dry during the day. If biochemical control is inadequ ate, 1 litre of dialysate is left in during the day. Indications for N IPD included social reasons and CAPD failure due to poor ultrafiltrati on or problems related to raised intra-abdominal pressure. Some featur es of biochemical control were less good with NIPD compared with CAPD with higher phosphate (2.18 mmol/l versus 1.83 mmol/l, P<0.001); creat inine (1256 mumol/l versus 1085 mumol/l, P<0.001); and potassium (4.92 mmol/l versus 4.64 mmol/l, P = 0.056) in patients changing between CA PD and NIPD. Overall peritonitis rate on NIPD was one episode per 47.1 months compared with a rate of one episode per 17.5 months for patien ts commencing CAPD over the same period. Conversion from CAPD to NIPD was successful in all six cases for problems related to raised intra-a bdominal pressure on CAPD and in six of nine patients transferred due to poor ultrafiltration. NIPD is a useful form of treatment and we bel ieve that the increased cost is offset by the reduced peritonitis rate .