Continuous ambulatory peritoneal dialysis with only three daily fluid exchanges.

IT is probably premature to assess the ultimate place of continuous ambulatory peritoneal dialysis (CAPD) in the treatment of chronic renal failure. However, of the fact that it has come to stay, there can be little doubt. This discussion will be divided into two parts: the first, a short description of the state of the art in the United Kingdom in 1980. The second, a brief account of CAPD experience in Liverpool, where we are trying to treat patients as cheaply as is compatible with a good quality of life. Drs. Ward and Gokal have kindly allowed me to quote, prior to publication, from their United Kingdom data on CAPD, which they collected during the summer months of 1980. Of the 44 units replying before the end of the survey, 27 are already doing CAPD. It is thought that by the end of 1980, the majority of United Kingdom dialysis units will hope to offer this form of treatment. Between them, these 44 units have already trained 220 patients, but half come from only three units. Thus, a large number of units will be cutting their teeth on CAPD during the next year. The units now experiencing an unduly high infection rate with intermittent peritoneal dialysis (IPD) may well be discouraged by their initial CAPD results: recent literature warns that proficiency with IPD is a pre-requisite for successful CAPD. The outcome in the first 220 patients is shown on table I.