Peritonitis remains a major cause of morbidity among patients on
peritoneal dialysis (PD), yet there is little information about the effect of new biocompatible
dialysis solutions on
peritonitis rates and treatment. In our unit, information on each
peritonitis episode is prospectively collected. Since 2003,
bicarbonate/
lactate dialysate has been gradually introduced for new patients and for patients experiencing
abdominal pain with conventional
lactate solutions. From 2002 to 2005, data from 121 episodes of
peritonitis (71 automated PD and 50 continuous ambulatory PD) were analyzed; 107 episodes occurred in patients using standard
lactate dialysate and 14 episodes in patients using
bicarbonate/
lactate solution. Patients using
bicarbonate/
lactate had a significantly lower
peritonitis rate of 1 per 52.5 patient-months compared to those using standard
lactate dialysate (1 per 26.9 patient-months) (P=0.0179). Response to treatment, however, was not affected by the type of
dialysate; cure rates (71.4 and 69.1%, respectively) and recurrence rates (21.4 and 15.8%, respectively) were not significantly different.
Catheter removal was required in three (21.4%) patients using
bicarbonate/
lactate and 23 (22.4%) patients using
lactate solution. Use of biocompatible
dialysate appears to reduce the
peritonitis rate by 50%, although this has to be confirmed in a randomized study. The type of
dialysate, on the other hand, does not affect response to treatment.