Clinical Pharmacy Care in Continuous Ambulatory Peritoneal Dialysis Patients

Abstract

Continuous ambulatory peritoneal dialysis (CAPD) continues to grow as a treatment modality for end-stage renal disease (ESRD). The high cost of care, multiplicity of drugs used by each patient, high cost of individual drugs, and high incidence of complications, make this patient population a challenging area for clinical pharmacy input. This article discusses the mechanics of CAPD, together with patient selection criteria, monitoring of the dialysis prescription, and infectious complications. The potential for research involving clinical pharmacists is discussed. Apart from studies on the pharmacokinetic disposition of drugs administered to CAPD patients, there remains a relative lack of information on many aspects of drug therapy. Recommendations for areas of continued study include the optimization of antibiotic therapy for peritonitis and exit-site infections, use of the intraperitoneal route for systemic effects of drugs, quality-of-life investigations, and stability studies of drugs in dialysate.