The CARI guidelines. Evidence for peritonitis treatment and prophylaxis: the influence of peritoneal dialysis systems and solutions on the incidence of peritonitis and catheter-related infections.

a. Disconnect systems of continuous ambulatory peritoneal dialysis (CAPD) result in lower rates of peritonitis than “spike” systems and this older system should no longer be used (Evidence level 1). b. Twin bag systems have lower rates of peritonitis than Y-disconnect systems (Evidence level 1) and are recommended as the preferred CAPD technique. c. There is insufficient high level evidence to support a difference in peritonitis rates when biocompatible fluids are used compared with standard dextrose solutions in peritoneal dialysis (PD) patients (Evidence level 2).