Effect of Exchange Systems and Procedure on Long Term Peritonitis in ESKD Patients Undergoing CAPD :A Retrospective Comparative Cohort Study
Keywords:
Incidence;, Exchange method;, Technique survival, Peritonitis-free survivalAbstract
Introduction. Peritoneal dialysis utilizes two distinct double-bag exchange systems (ANDY-Disc from Fresenius Medical Care in Bad Homburg, Germany, and DIANEAL from Baxter in Deerfield, IL).
These systems are widely used across the globe. The long-term outcomes of peritonitis with different types of treatment are still questionable. Therefore, we conducted a retrospective comparative cohort study to assess the long-term impact of these two distinct exchange procedures on the true peritonitis rate and the technique durability in real-world settings.
Methods. One hundred and twenty patients, treated with a double-bag exchange system in a Songklanagarind Hospital, located in the south of Thailand from January 2009 to December 2020 were included. The primary outcome was the incidence rate of peritonitis by treatment arm (ANDY-disc and DIANEAL). Secondary outcomes included the pathogenic organism causing peritonitis, time to the first peritonitis, and survival technique between the two systems.
Results. The peritonitis rate for patients using the ANDY-disc in continuous ambulatory peritoneal dialysis (CAPD) was 0.28 episodes per patient-year, while the DIANEAL group had a rate
of 0.29 episodes per patient-year. There was no difference in the peritonitis rate between the two groups (P = .816). Gram-positive bacterial peritonitis accounted for 33.4% in the ANDY-disc arm
and 43.7% in the DIANEAL arm. The 10-year technique survival was 86.1% in the ANDY-Disc group and 73.5% in the DIANEAL group; this did not reach statistical significance.
Conclusion. The ANDY-Disc and DIANEAL exchange systems are comparable in the long-term incidence of peritonitis. Both systems have similar long-term technique survival. However, this should be confirmed by a high-quality trial.
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