The problems of peritoneal dialysis in the management of chronic uraemia in Nigeria.

The problems encountered in the use of peritoneal dialysis (PD) in the initial management of patients with chronic renal failure in Nigeria were highlighted, studying 23 patients (13 males and 10 females) aged between 15 and 68 years (mean age 36.4 years). Peritonitis was the most common complication, occurring in 16 (70%) of patients; effluent drainage obstruction in 11 patients (48%); haemorrhagic effluent in 10 patients (44%); fluid leak from catheter site infection in 7 patients (30%); accidental disconnection of line/catheter joint in 5 patients (22%); and catheter site infection in 2 patients (9%). A positive effluent culture was found in only 4 out of 18 cultured samples, with Klebsiella and Staphylococcus aureus being the organisms isolated. Dialysis was terminated in patients for the following reasons: financial constraints (8 patients), unresolving peritonitis (7 patients), drainage problems (3 patients), and clinical improvement (5 patients). The study concludes that PD in the management of chronic uraemia in developing countries, while producing clinical benefits in the majority of patients, is still not generally acceptable as a long-term treatment modality in view of the number of problems.