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When I was assigned my first patient on acute peritoneal dialysis (PD) in the 1970s, we used 2- liter glass bottles of dialysis solution warmed in a water bath, and dialysate was drained into open graduated cylinders. A few years later, the first patients on continuous ambulatory peritoneal dialysis (CAPD) performed a connection procedure to a Y-set for every single exchange. The early CAPD prescription was “one size fits all” – five  2-liter exchanges per day. And the peritonitis rate was high, one episode every 4-6 weeks, yet the survival was similar to that of patients on hemodialysis (HD).
 

Barbara F. Prowant, MS, RN, CNN, is Research Associate, Division of Nephrology, School of Medicine, University of Missouri-Columbia Dialysis Clinic, Inc., Columbia, MO. Ms. Prowant is a prominent author on peritoneal dialysis issues, having published numerous journal articles and textbook chapters on the specialty. She is a past ANNA National Secretary and a member of ANNA’s Central Missouri Chapter.

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