Peritonitis in Infants and Children on CAPD/CCPD

Infections, primarily those of peritonitis and catheter exit site, are complications of the chronic peritoneal dialysis therapies for children and adults, despite years of experience with these techniques [1–8]. These problems are shared by the two most frequently used forms of maintenance peritoneal dialysis, continuous ambulatory peritoneal dialysis (CAPD) and continuous cycling peritoneal dialysis (CCPD) [9–19]. The same can be said for any variation in either of these two methods, an example being a regimen composed of nightly dialysis, utilizing the concepts of what historically has been termed intermittent peritoneal dialysis (IPD) [2–5, 20–22]. Thus, the clinical import of infectious complications would appear to be the same regardless of the particular form of chronic peritoneal dialysis used, assuming no alterations in the basic procedure. Recurring or unresponsive peritonitis or chronic exit site infection continue to be responsible for a considerable number of treatment interruptions or failures, as well as concern regarding associated morbidity and mortality [9–14, 23–27, 30, 31]. Discouraging and persistent problems of this kind can lead to the abandonment of peritoneal dialysis in some dialysis programs.