ABSTRACT
Introduction In 1975 Robert Popovich and Jack Moncrief described the concept of Continuous Ambulatory Peritoneal Dialysis (CAPD), and shortly thereafter commenced their first patient on this form of therapy. Although Intermittent Peritoneal Dialysis (IPD) had been used successfully prior to this time, its application was limited by high rates of peritonitis, and CAPD soon became the favoured method of treatment. Most centres prescribed what became known as the ‘standard’ treatment prescription-two litre exchanges four times per day. There was little appreciation of the importance of residual renal function, or the need for more exchanges and/or higher volumes for people with larger dialysis requirements. High rates of peritonitis continued, causing a loss to haemodialysis of about 20% annually. Several significant advances have occurred during the past decade. They include the development of different treatment possibilities, individualised treatment prescriptions and the concept of ‘flush before fill’ bag change procedures designed to decrease peritonitis rates.
