CKD-CONTINUOUS AMBULATORY PERITONEAL DIALYSIS (CAPD)

SUMMARY

1. Close attention to nutritional status-a high-protein intake is necessary.

2. Fluid shifts are more gradual, so CAPD causes less strain on the heart.

3. The patient infuses 2-3 L of hypertonic dextrose solution into the peritoneal cavity (subsequently drained by gravity) 4-6/day. Many patients receive their PD exchanges at night using an automated cycler (called continuous cycler peritoneal dialysis, CCPD).

4. Main complication is peritonitis, usually caused by gram-positive skin flora (commonly S. epidermidis or S. aureus ), and gram-negative organisms.

5. Peritonitis should be suspected when the cell count of peritoneal fluid shows > 100 cells with > 50% PMNs.

6. Empiric intraperitoneal therapy with broad-spectrum abx should be initiated in suspected peritonitis pending C/S.

7. Other issues - high protein loss, hernias, hydrothorax, loss of water-soluble vitamins.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].