Automated peritoneal dialysis for home use.

In order to provide an alternative to maintenance home dialysis for patients remotely situated or who had vascular access failure, a parallel peritoneal dialysis (PD) program was developed in March 1972. Over four years, 36 patients started PD with the intention of carrying out home treatments. Thirty of the 36 succeeded and 22 completed at least six months of home treatments, seven have so far been treated for over one year. No neuropathy developed except in diabetic patients. No patient, including four who had undergone bilateral nephrectomy, was depenedent on blood transfusions. Predialysis serum creatinine values were questionably higher (p less than 0.07) in a group of six patients who at another time had been maintained on hemodialysis (HD). In this group serum albumin was (mean +/- 1 S.D.) 3.3 +/- 4 g/100 ml on PD and 3.8 g/100 ml on HD (p less than 0.05). Sixteen of the 36 patients had bacterial peritonitis on 22 occasions; the average incidence was once every 14 months of patient exposure. An epidemic of sterile peritonitis involving 40 episodes in 16 patients was resolved after machine techniques were changed. Catheter failure occurred in 15 of the 22 patients in the long-term group, but catheter replacement was not difficult.